Full Name:

Institution:

Matric No./State Code:

Email:

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Gender: Select Gender Male Female

Date of Birth:

Qualification:

State of Origin: Select a state Abia Adamawa Akwa Ibom Anambra Bauchi Bayelsa Benue Borno Cross River Delta Ebonyi Edo Ekiti Enugu Gombe Imo Jigawa Kaduna Kano Katsina Kebbi Kogi Kwara Lagos Nasarawa Niger Ogun Ondo Osun Oyo Plateau Rivers Sokoto Taraba Yobe Zamfara

LGA of Origin: Select a state first

Permanent Home Address:

Do you have any professional certificate? Yes No

COURSE(S) APPLIED FOR: Human Resources Management (HRM)
Human Resources Development and Productivity (HRDP)
Leadership Skills and Administrative Management (LSAM)
Customer Relationship Management (CRM)
Health Safety and Environment (HSE)
Environmental Impact Assessment (EIA)
Quality Control and Assurance (QCA)
Project Management Professional (PMP)

I solemnly hereby declare that the information provided above is my true/authentic information to the best of my knowledge. I authorize Ufua Prosperous Project Management International to investigate/verify same and take action as deemed fit if ANY information is found to be false/untrue or misleading.