DELTA STATE COLLEGE OF NURSING SCIENCE
PMB.120,AGBORDELTASTATENIGERIA
NURSING ADMISSION APPLICATION FORM
ADMISSION FORM FOR 2026/2027 ACADEMIC SESSION
STUDENT INFORMATION
Form No:07859
NameofStudent:
JambRegNo/Score:
Nextofkin:
Sex:Male Female
D.O.B:
PhoneNo:
Email:
L.G.A:
StateOf Origin:
PermanentHomeAddress:
CurrentQualification:
Sponsor Name:
Place of Work:
PhoneNumber:
Sponsor’s Details:
ATTESTATION
I, hereby declare that i am not a member of any secrete cult and that the information I have provided above is true and correct this day of , 2026.
STUDENT SIGN
PARENT/GUARDIAN SIGN
FIRST EXAMINATION SITTING:
SSCE .: WAEC: NECO: NABTEB: GCE:
SUBJECT GRADE 1. English Language
Mathematics
SECOND EXAMINATION SITTING: SUBJECT
1. English Language
2. Mathematics GRADE
FOR OFFICIAL USE ONLY
NAME OF COORDINATOR:
COMMENT:
DATE OF REGISTRATION:
SIGNATURE: