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Student Information

First Name *

Last Name *

Middle Name

Gender *

Date of Birth *

Nationality *

State of Origin *

Local Government Area

Residential Address *

Class Applying For *

Present School

Present Class

Why do you want to join Cilreigns Academy?

Parent/Guardian Name *

Relationship *

Phone Number *

Email Address *

Occupation

Office Address

Emergency Contact

Please upload clear, readable scanned copies or photos of the following documents (Max 2MB each, JPG/PNG/PDF)

Passport Photograph *

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Birth Certificate *

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Last Report Card

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Immunization Record

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I confirm that all information provided is accurate and I agree to the terms and conditions of admission.