NATIONAL YOUTH SERVICE CORPS
2021 MOBILIZATION FORMAT
Recent
Passport
Photograph
Data on Prospective Corps Members
MATRIC NUMBER (In Full)
FIRST NAME
MIDDLE
SURNAME
GENDER
MARITAL STATUS
GSM NUMBER
STUDY MODE (Full Time)
STATE OF ORIGIN
DATE OF BIRTH
COURSE OF STUDY
CLASS OF DEGREE
YEAR OF GRADUATION
JAMB REGISTRATION NUMBER
QUALIFICATION
STUDENT’S E-MAIL
_____________________________________
____________________________________
PROSPECTIVE CORPS MEMBER’S
SIGNATURE
AND DATE
HEAD OF DEPARTMENT SIGNATURE,
STAMP AND DATE
_______________________________
STUDENT’S AFFAIRS OFFICER’S
SIGNATURE
Please ensure that your information is duly typed and attach your recent JAMB Admission letter/or
JAMB Result slip via www.jamb.org.ng/efacility