DELTA STATE COLLEGE OF NURSING SCIENCE
PMB. 120 SAPELE, DELTA STATE
ADMISSION APPLICATION FORM ADMISSION FORM FOR 2026/2027 ACADEMIC SESSION
STUDENT INFORMATION FormNo: 07859
Name of Student:
Desired Course Of Study:
Next of kin:
Sex: Male Female
D.O.B:
Phone No:
Email:
L.G.A:
State Of Origin:
Permanent Home Address:
Current Qualification:
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
FIRST EXAMINATION SITTING:
SSCE .: WAEC: NECO: NABTEB: GCE:
SUBJECT GRADE
1. English Language 2. Mathematics
SECOND EXAMINATION SITTING:
SUBJECT GRADE
1. English Language
2. Mathematics
FOROFFICIAL USE ONLY
NAME OF COORDINATOR:
COMMENT:
DATE OF REGISTRATION:
SIGNATURE: NAME OF COORDINATOR: