New NYSC Form – Fountain University Osogbo

FUO Finalists Name Rendition

This form is to be filled by all 400 Level students. All students are to take extra caution while filling this

PART A (Personal Data)

Surname(Required)

First Name(Required)

Middle name

State of irigin

Email(Required)

JAMB Reg Number

NIN Reg Number(Required)

College(Required)

Department(Required)

Course of Study(Required)

Enter your course of study e.g B.Sc Computer Science

Matric Number(Required)

Phone Number(Required)

Date of Birth

Gender

Marital Staus

PART B (Confirmation of Name Rendition)

O Level Result (Write your name as it appears on the letter)(Required)

Jamb Admission Letter (Write your name as it appears on the Letter)(Required)

Name as it appears on spreadsheet result(Required)

Reason for disparity (if any)

Evidence (Documents) in support of the above to be attached

Drop files here or

Max. file size: 128 MB.

PART C (request/Appeal)

I want my name to be rendered as follows(Required)

PART D:

Passport Photo(Required)

Max. file size: 128 MB.

Undertaking(Required)

I agree with the below

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