DELTA STATE COLLEGE OF NURSING SCIENCE
PMB. 120, AGBOR DELTA STATE NIGERIA
NURSING ADMISSION APPLICATION FORM
ADMISSION FORM FOR 2026/2027 ACADEMIC SESSION
STUDENT INFORMATION
Form No:07859
Name of Student:
Jamb RegNo/ Score:
Next of kin:
Sex: Male Female
D.O.B:
Phone No:
Email:
L.G.A:
State Of Origin:
Permanent Home Address:
CurrentQualification:
Sponsor Name:
Place of Work:
Phone Number:
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
SSCE .: WAEC: NECO: NABTEB: GCE: FIRST EXAMINATION SITTING: SUBJECT
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: