Confirmation Of Name Rendition

	FOUNTAIN UNIVERSITY , OSOGBO
	P.M.B.4991, OSOGBO , OSUN STATE.
	Academic Affairs Office
	Confirmation Of Name Rendition

Fullname *

First

Middle

Last

JAMB Registration Number *

NIN Reg. No *

College *

Department *

Course of study *

Matriculation Number *

Phone Number *

Gender

Address

Address Line 1

City

State / Province / Region

Country

Marital Status

Date of Birth

O'level Result: Write your name as it appears on the Certificate

Jamb Admission Letter: Write your name as it appears on the letter

Name as it appears on spreadsheet Result

Any Reason For Disparity?

Type The Format you want your name to be written below:

Attestation *

I hereby write to undertake that in the event that information above is found to be incorrect or incase of request for correction of name by me, it should be treated as breach of trust and appropriate sanction should be taken against me.

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Student's signature and Date

FOUNTAIN UNIVERSITY , OSOGBO