NIGERIAN ARMY

e-Recruitment Portal Application Form

66th Regular Recruits Intake for

Tradesmen/Women

G7 : ELECTRICIANS

PERSONAL INFORMATION (Section A)

Application Number 66RR1/11/AB/G7/0013675

Title Mr

Surname OBA

First Name NNAEMEKA

Other Names CHUKWUDIMMA

Date Of Birth 01-Jan-1987

Place Of Birth ENUGU

State Of Birth Enugu

State Of Origin Abia

LGA Of Origin Obi Ngwa

Gender Male

Height (meters) 5.70

Marital Status Single

Religion Christianity

No Of Children 0

Permanent Address 1 110 AMECHI ROAD,TOPLAND, ENUGU.

Permanent Address 2 110 AMECHI ROAD,TOPLAND, ENUGU.

LGA of Permanent Address Enugu South

State of Permanent Address Enugu

Contact Address 1 110 AMECHI ROAD,TOPLAND, ENUGU.

Contact Address 2 110 AMECHI ROAD,TOPLAND, ENUGU.

LGA of Contact Address Enugu South

State of Contact Address Enugu

Mobile Number 08062380181

email Address nnaemekaoba@yahoo.com

Hobbies/Games FOOTBALL

NEXT OF KIN INFORMATION (Section B)

Title Mr

Surname OBA

First Name ABUCHI

Other Name MICHAEL

Relationship to Next of Kin Brother

Next of Kin Address 1 110 AMECHI ROAD,TOPLAND, ENUGU.

Next of Kin Address 2 110 AMECHI ROAD,TOPLAND, ENUGU.

Next of Kin Address LGA Enugu South

Next of Kin Address State Enugu

Occupation of Next of Kin TRADER

Post of Next of Kin TRADER

PARENTS/GUARDIAN INFORMATION (Section C)

Title Mr

Parent/Guardian Surname OBA

Parent/Guardian First Name MICHAEL

Parent/Guardian Other Names A.N

Parent/Guardian Address 1 110 AMECHI ROAD,TOPLAND, ENUGU.

Parent/Guardian Address 2 110 AMECHI ROAD,TOPLAND, ENUGU.

Parent/Guardian Address LGA Obi Ngwa

Parent/Guardian Address
Abia
State
EDUCATION INFORMATION (Section D)
1. School Name INYISHI COMMUNITY SECONDARY SCHOOL.

School Address INYISHI, IKEDURU

Qualification Obtained SSCE (NECO).

Year Of Graduation 2001

ENGLISH LANGUAGE E8, MATHEMATICS D7,

IGBO LANGUAGE C5,, ECONOMICS D7, BIOLOGY
Grades Obtained
C5, CHEMISTRY C6, HEALTH SCIENCE C5,
PHYSICS C6, AGRICULTURAL SCIENCE D7.

REFEREE INFORMATION (Section E)

Names and addresses of Three (3) Referees

1. Title Mr

Surname OBA

First Name MICHAEL

Other Names

Contact Address 110 AMECHI ROAD, TOP-LAND, ENUGU.

Phone 07038915827

2. Title Mr

Surname NWAGBARA

First Name UDO

Other Names

APOSTOLIC FAITH CHURCH,UMUOKATAWOM,

Contact Address
OBINGWA L.G.A ABIA STATE.

Phone 08068962028

3. Title Mrs

Surname MICHAEL

First Name NGOZI

Other Names

APOSTOLIC FAITH CHURCH, OBINGWA L.G.A

Contact Address
UMUOKATAWOM, ABIA STATE.

Phone 07036526740
FURTHER INFORMATION (Section F)
Have you ever served in the Armed Forces (Army, Air
No
Force, Navy, etc)?

Give Details if Yes

Reason for leaving the

service

Have you ever been detained in any Police Station? No

State Reasons if Yes

Duration of Detention

Have you ever been Convicted by a Court of Law? No

State Reasons if Yes

Duration of Conviction

Have you ever travelled out of the country? No

Do you have any relation serving/retired in the Armed

No
Forces?
66RR1/11/AB/G7/0013675
_________________________________________________________________________

_________________________________________________________________________

Date Received

APPLICANT'S DECLARATION (Section G)

I OBA NNAEMEKA CHUKWUDIMMA, hereby declare that the information given in this application
is true and that if found to be false I should be prosecuted.

Referee Applicant
Name ____________________________ Name ____________________________

Address ____________________________ Address ____________________________

Signature ____________________________ Signature ____________________________

CERTIFICATION BY PARENTS/GUARDIAN (Section H)

I OBA MICHAEL A.N, parent/guardian of OBA NNAEMEKA CHUKWUDIMMA who is applying for the
66th Regular Intake into the Nigerian Army, hereby certify that I fully understand that my
child/ward will if required to attend the Recruitment Exercise shall not demand
compensation or relief from the Government in respect of death or any injury which my
child/ward may sustain in the course of or as a result of any task given to him/her during
the exercise.

Witness
Name ____________________________

Address ____________________________

Signature ____________________________
CERTIFICATION BY THE CHAIRMAN/SECRETARY OF THE APPLICANT'S LOCAL
GOVERNMENT AREA/MILITARY OFFICER OF LIEUTENANT COLONEL/EQUIVALENT AND
ABOVE OR POLICE OFFICER OF ACP AND ABOVE (Section I)

I certify that the applicant MR OBA NNAEMEKA CHUKWUDIMMA is an indegene of Obi Ngwa L.G.A.
of Abia and that to the best of my knowledge and belief the facts stated on the form are
correct. And I hereby declare that if any statement made in connection with this
application is proven to be false I should be prosecuted.

Name ____________________________

Address ____________________________

Signature (Council Stamp) ____________________________

CERTIFICATION BY DPO OF APPLICANT'S POLICE AREA OF JURISDICTION (Section

J)

I certify that the applicant MR OBA NNAEMEKA CHUKWUDIMMA is an indegene of Obi Ngwa L.G.A.
and that his/her parent hails from Obi Ngwa L.G.A. of Abia. That he/she has no criminal
record on him/her. If any state briefly ______________
_____________________________________ That to the best of my knowledge and belief the
facts stated in the form are correct and I hereby declare that if any statement made in
connection with this application is proven to be false I should be prosecuted.

DPO

Name ____________________________

Address ____________________________

Signature ____________________________
FOR OFFICIAL USE ONLY
_________________________________________________________________________

OBA NNAEMEKA CHUKWUDIMMA[66RR1/11/AB/G7/0013675]

_________________________________________________________________________

Date Received ____________________

Number Of Credits/Passes obtained

a) Trade Test Cert: ___________________________________________________________

b) SSCE: ___________________________________________________________

c) GCE: ___________________________________________________________

d) NECO: ___________________________________________________________

e) OND: ___________________________________________________________

Documents Attached

a) ___________________________________________________________

b) ___________________________________________________________

c) ___________________________________________________________

Detailed Result

a) Medical fitness: __________________________________________________

b) General aptitude test __________________________________________________

score:

c) Vocational aptitude __________________________________________________

test score:
Remarks

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

a) Rank: __________________________________________________

b) Name: __________________________________________________

c) Signature and __________________________________________________

Date:

Director DARRR

a) Rank: __________________________________________________

b) Name: __________________________________________________

c) Signature and __________________________________________________

Date: