GEON

EU

O R

NNPC/BELEMAOIL JV 2018/2019 SCHOLARSHIP APPLICATION FORMUNDER-GRADUATE

Please ensure forms are filled in capital “(a)” letter boldly and all required documents are duly attached.

APPLICANT INFORMATION:

NAME:SURNAME FIRST NAME MIDDLE NAME

SEX: Date of Birth:

PHONE: EMAIL:

STATE: LGA: COMMUNITY:

ADDRESS:

EDUCATION INFORMATION:

CURRENT INSTITUTION :

YEAR OF ENTRY: PROJECTED GRADUATION DATE:

COURSE:

MODE OF ADMISSION: DURATION OF PROGRAMME:

CGPA:

ACCOUNT DETAILS:

BANK NAME: ACCOUNT NUMBER:

ACCOUNT NAME:

SORT CODE:

Are you related to any Belemaoil Producing Ltd Staff (Yes/No)?

If yes, State the name of the staff and nature of relationship:

Community Representative:(CDC INTERFACE CHAIRMAN) NAME SIGNATURE/DATE

STUDENT SIGNATURE:

2 recent passport photographs

GEON

EU

O R

NNPC/BELEMAOIL JV 2018/2019 SCHOLARSHIP APPLICATION FORMUNDER-GRADUATE

ASSEMBLE AND ATTACH TO THIS APPLICATION THE FOLLOWING DOCUMENTS:

1. Scholarship Application Form (Properly Filled with Passport Photograph at the top)2. University Admission Letter3. JAMB Admission Letter4. Transcript (where applicable) or 1st Year Result5. O’ Level Result6. Local Government Identification Letter7. Letter of Identification (Signed by either Traditional Ruler, or Community Representative)

NOTE: Belemaoil does not demand any form of payment from applicants. The application is entirely free of charge.

FOR OFFICIAL USE ONLY:

Applicants Form Reviewed

Documents Completed

Documents Verified

Applicant Form Approved

Applicant Form Not Approved

Reasons for Non-Approval:

Name & Signature of Reviewing Officer

Managers Signature