Phone: +234-703-151-2126
Email: info@bamaje.com.ng
BAMAJE DRIVING ACADEMY
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REGISTRATION FORM
Gender
*
Please Select
Male
Female
Date Of Birth
*
Licence Class
*
Please Select
A
B
D
J
Blood Group
*
Please Select
0-
0+
A-
A+
B-
B+
AB-
AB+
Unknown
Facial Mark
*
Please Select
Yes
No
Eye Glass
*
Please Select
Yes
No
Height
*
Disability
*
Please Select
Yes
No
National ID NO
Unique Tax Payer Identification NO
Next Of Kin Phone Number
*
Nationality
*
-Choose Nationality-
Nigerian
Others
State
*
---select state---
Local Govt
*
---select L.G---
Contact Address
*
City
State
*
Postal Code
Mobile No
*
Email Address
Do you have your personal car
*
Please Select
Yes
No
Do you have any driving experience
*
Please Select
Yes
No
DECLARATION
I declare that the information given correct and agree to abide by the rules and regulations of the school and also agree to be responsible for any damages caused by me to the school vehicle. Form should be submitted to the office with flat file and two resent passport.
Signature .....................................................................................................................................
Date ........................................................................................................................................................
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