Federal Colleges Form

Federal Government Schools
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Surname
First name
Middle name
Date of birth

DayMonthYear
Religion
Sex

FemaleMale
State of Origin
Local Governmet
Any disability

YesNo
Phone Number

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Applicant School
Class
First Choice
Second Choice
Head Teacher Name & Phone
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