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Please complete the form below to apply for admission to
Foresight -- WUSHISHI
Student Info
Title
Select Title
Mr
Mrs
Miss
Ms
Dr
Prof
Surname (Last Name)
First Name
Other Name
Email address
Please enter a valid and working email address
Phone number
Date of birth
Marital Status
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Single
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Divorced
Widowed
Gender
Select Gender
Male
Female
Blood Group
Select Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Nationality
State of Origin
LGA
Religion
Next of Kin Info
Next of Kin Name
Relationship
Next of Kin Phone
Next of Kin Email
Next of Kin Address
Other Info
Entry Type
Please select
Undergraduate
Transfer
Direct Entry
Secondary School Name
Secondary School Location (state)
Graduation Date
How did you hear about Foresight -- WUSHISHI?
First Program Choice
Please select
DIPLOMA COMMUNITY HEALTH
PUBLIC HEALTH
PHARMACY TECHNICIAN
MEDICAL LOBORATORY TECHNICIAN
HEALTH INFORMATION MANAGEMENT
Second Program Choice
Please select
DIPLOMA COMMUNITY HEALTH
PUBLIC HEALTH
PHARMACY TECHNICIAN
MEDICAL LOBORATORY TECHNICIAN
HEALTH INFORMATION MANAGEMENT
Number of O'level sittings
Please select
One
Two
O'Level 1st Sitting - Subjects and Grades
If awaiting results, please fill grade as AR.
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
O'Level 2nd Sitting - Subjects and Grades
If awaiting results, please fill grade as AR.
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
Subject
Grade
I confirm that my entire details are
correct and accurate and I don't have duplicate subjects in my O'Level and Jamb details
and that this form cannot be edited after I have submitted.
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