CJVS Initiative

Registration Form

Please fill in all required fields (*)

Personal Information

Surname *

First Name *

Middle Name

Gender *

Date of Birth *

Nationality *

State of Origin

Local Government Area

Contact Information

Email Address *

Phone Number *

Alternate Phone Number

WhatsApp Number

Residential Address *

City *

State *

Postal Code

Program Selection

Select Program *

Study Mode *

Intake Session *

Educational Background

Highest Qualification *

Institution Attended

Field of Study

Year of Graduation

Professional Information

Current Occupation *

Organization / Employer

Years of Work Experience

Professional Body Membership

Payment Information

Payment Option *

Full Payment (5% discount)

Installment (50% now, 50% by Week 4)

NGO/Organization Sponsorship

Payment Method

Payment Reference Number

Account Details: Bank: [Insert Bank] | Account Name: CJVS Initiative | Account No: [Insert]

Document Upload

Passport Photograph * JPEG or PNG, max 2MB

Curriculum Vitae / Resume PDF or Word, max 5MB

Highest Certificate/Transcript PDF or Image, max 5MB

Recommendation/Reference Letter PDF or Word, max 5MB

Emergency Contact

Emergency Contact Name *

Relationship *

Emergency Phone Number *

Emergency Email

Additional Information

How did you hear about us?

Why are you interested in this program?

What are your expectations from this program?

Special Needs or Accommodations

I confirm that all information provided is accurate and complete. *

I consent to the collection and processing of my data for registration and academic purposes. *

I confirm that I have read and agree to the payment terms and conditions. *

Student Registration