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Application Form
Application Number
NNR37/2024/OYO/672/0033055
National Identification Number
16766726988
Bank Verification Number
22383850324
Category
IT
Exam State
Oyo
Exam Center
HQ 2 DIV IBADAN
Title
Miss
Surname
Teslim
First Name
Ikimot
https://nnrportal.azurewebsites.net/ratings/Form 11/18/24, 8 53 AM
Page 1 of 15
:
Other Name
Omolara
Height
1.60
Religion
Islam
Marital Status
Single
Gender
F
Date Of Birth
Saturday, May 25, 2024
State of Origin
Oyo
LGA of Origin
Oluyole
Mobile Number
08110531416
Home Town
Oyo
Permanent Address
Abuja gwagwalada
Parent/ Guardian Detail
Full Name
Titilayo Quyum
Contact Address
Gwagwalada abuja
Next Of Kin
Full Name
Quyum
Relationship
Family
Mobile Number
8151699386
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Occupation
Student
Contact Address
Gwagwalada Abuja
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Application Form
Referee Details
Referee Name Phone Referee Address
Quyum Rasidat 09157764897 Chukuku glo mask gwagwalada abuja
Tesleem ola 0902 756 5228 Ibadan academy
Primary Details
School Qualification From To
Lizard nursery & primary school fslc 2001 2009
Secondary Details
School Qualification From To
Lizard nursery & primary school waec 2013 2015
SSCE / NECO / WASSCE / GCE
Subject Grade Examination
Mathematics A1 EXCELLENT 4260924102
English C6 CREDIT 4260924102
Biology B2 VERY GOOD 4260924102
Literature-in-English C4 CREDIT 4260924102
Civic Education B3 GOOD 4260924102
Christian Religious Studies A1 EXCELLENT 4260924102
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Tertiary Details
Institution Course of Study Type From To Grade
University of abuja Admin & planning ond 2020 2024 lower_credit
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Application Form
APPLICANT'S DECLARATION
Application Number
NNR37/2024/OYO/672/0033055
Application Number: NNR37/2024/OYO/672/0033055

I Teslim Ikimot, hereby declare that the information given in this application is true and that if found
to be false I should be prosecuted.
Signature: _______________________________ Date: _______________________________
Certification by Parents / Guardian
I _____________________________________ parent/guardian of ______________________________________, who is

applying for recruitment into the Nigerian Navy, hereby certify that I fully understand that my
child/ward will (if required to) attend the Recruitment Exercise and I 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.
Parent / Guardian Witness
Name: _________________________________ Name: _________________________________
Address: _______________________________ Address: _______________________________
Signature: _______________________________ Signature: _______________________________
Date:_______________________________ Date:_______________________________
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:
Application Form
LOCAL GOVERNMENT AREA CERTIFICATION
Application Number
NNR37/2024/OYO/672/0033055
Title
Miss
Surname
Teslim
First Name
Ikimot
Other Name
Omolara
Height
1.60
Religion
Islam
Marital Status
Single
Gender
F
Date Of Birth
Page 7 of 15
:
State of Origin
Oyo
LGA of Origin
Oluyole
Mobile Number
08110531416
Home Town
Oyo
Permanent Address
Abuja gwagwalada
Certification by LGA Chairman / Secretary Or Senior Military

O!cer not below the rank of Commander or equivalent Or Chief
Superintendent Of Police from Applicant's State of Origin
I certify that the applicant ____________________________________________ is an indigene of

_____________________________ L.G.A, ________________ State, and that to the best of my knowledge and
belief, the facts stated on the form are correct. 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:_________________________________________
Date:_________________________________________
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:
Application Form
POLICE CERTIFICATION
Application Number
NNR37/2024/OYO/672/0033055
Title
Miss
Surname
Teslim
First Name
Ikimot
Other Name
Omolara
Height
1.60
Religion
Islam
Marital Status
Single
Gender
F
Date Of Birth
Page 9 of 15
:
State of Origin
Oyo
LGA of Origin
Oluyole
Mobile Number
08110531416
Home Town
Oyo
Permanent Address
Abuja gwagwalada
Certification by LGA Chairman / Secretary Or Senior Military O!cer not below

the rank of Commander or equivalent Or Chief Superintendent Of Police from
Applicant's State of Origin
I certify that the applicant ____________________________________________ is an indigene of
_____________________________ L.G.A, ________________ State, and that to the best of my knowledge and
belief, the facts stated on the form are correct. 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:_________________________________________
Date:_________________________________________
Certification by Divisional Police O!cer
I certify that the applicant _________________________________ is an indigene of
______________________Town, _________________________ L.G.A, ________________ State and that his/her
parent hails from __________________________ L.G.A. of _________________ State. 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.
Name:_______________________________
Address:_______________________________
Signature:_______________________________
Date:_______________________________
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GUARANTOR'S Certification
Application Number
NNR37/2024/OYO/672/0033055
Title
Miss
Surname
Teslim
First Name
Ikimot
Other Name
Omolara
Height
1.60
Religion
Islam
Marital Status
Single
Gender
F
Date Of Birth
Page 11 of 15
:
State of Origin
Oyo
LGA of Origin
Oluyole
Mobile Number
08110531416
Home Town
Oyo
Permanent Address
Abuja gwagwalada
Particulars of Guarantor
Surname: ______________________________________ First Name: ____________________________________

Middle Name: _________________________________ Town: _________________________________________
LGA: __________________________________________ State of Origin: ________________________________
Mobile: ________________________________________ E-mail: ________________________________________
Appointment: __________________________________ How long have you known the candidate:_______
Formation/Unit/O!ce Address: _________________________________________________________________
Residential Address: ___________________________________________________________________________
Contact Address: ______________________________________________________________________________
Name: ______________________________________
Address: __________________________________________________________________________
Signature:__________________________________________
Date:________________________________________
This form is to be filled by a Military O!cer not below the rank of Lt Col or equivalent/Police
O!cer not below the rank of Chief Superintendent of Police/Assistant Director at either
Federal or State Civil Service certifying the eligibility of the applicant. You need not to come from
an applicant’s State of Origin to guarantee him/her only be sure of the character. Please note that
inability to confirm the above given information about you, will lead to automatic disqualification of
the candidate.
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Application Form
FOR OFFICIAL USE ONLY
Application Number: NNR37/2024/OYO/672/0033055

Applicant's Full Name: Teslim Ikimot
Date Received:_____________________________________
Education Qualification: Number Of Credits/Passes obtained (SSCE / GCE / WASCE / NECO):_______
Documents Attached
a)_____________________________________________________
b)_____________________________________________________
c)_____________________________________________________
d)_____________________________________________________
e)_____________________________________________________
Detailed Result
Medical fitness:_____________________________________________________
General aptitude test score:_____________________________________________________
Vocational aptitude test score:_____________________________________________________
Remark
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________
Director
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________
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Application Form

Parent/ Guardian Detail

Referee Name Phone Referee Address

Quyum Rasidat 09157764897 Chukuku glo mask gwagwalada abuja

Tesleem ola 0902 756 5228 Ibadan academy

Lizard nursery & primary school fslc 2001 2009

School Qualification From To

Lizard nursery & primary school waec 2013 2015

SSCE / NECO / WASSCE / GCE

Subject Grade Examination

Mathematics A1 EXCELLENT 4260924102

English C6 CREDIT 4260924102

Biology B2 VERY GOOD 4260924102

Literature-in-English C4 CREDIT 4260924102

Civic Education B3 GOOD 4260924102

Christian Religious Studies A1 EXCELLENT 4260924102

Institution Course of Study Type From To Grade

University of abuja Admin & planning ond 2020 2024 lower_credit

Application Number: NNR37/2024/OYO/672/0033055

Signature: _______________________________ Date: _______________________________

Certification by Parents / Guardian

I _____________________________________ parent/guardian of ______________________________________, who is

Certification by LGA Chairman / Secretary Or Senior Military

I certify that the applicant ____________________________________________ is an indigene of

Certification by LGA Chairman / Secretary Or Senior Military O!cer not below

Surname: ______________________________________ First Name: ____________________________________

Application Number: NNR37/2024/OYO/672/0033055

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