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Registeration Form

Fidei Polytechnic, Gboko
Mama Anna Ijir Akume
Centeral Resource Centre
e-registration Students Entry Form (eRSEF)

Student Registration Mandatory fields are marked with * Personal Data
ID: *
First Name: *
Last Name: *
Other Name:
Title: *
State of Origin: *
Country: *
Marital Status: *
Date of Birth: *	/ / (YYYY / MM / DD)
Contact Information
Email:
	Make sure that your Email address is correct. It will be used to retrieve lost password. You can Create a free Gmail account.
Mobile Phone: *
Home Phone:
Work Phone:
Fax:
Street Address: *
Academic Information
Program: *
School: *
Department: *
Account Information
PIN Number: *
User Name: *
Password: *
Confirm Password: *
I agree to the * Terms & Conditions