Surname:

First Name:

Other Names:

Nationality:

Date of Birth (dd/mm/yy):

Gender:

Name you would like to be called:

Marital Status:

Name of Spouse (if any):

No. of Children (if any):

Religion:

Hobbies:

Residential Address:

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Telephone number(s):

Postal Address:

Email Address:

Current Job Title:

Duration of Job:

Company name:

Company products and services:

Date joined organization:

No. of employees under direct
responsibility (if any):

Information in this form is for the use of SMC only and considered strictly confidential.
SMC reserves the right to reject the application if the information submitted is seen to be false or incomplete.

Date (year):

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Location:

Institution:

Qualifications Obtained:

Date (year):

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Finish

Location:

Institution:

Qualifications Obtained:

Date (year):

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Finish

Location:

Institution:

Qualifications Obtained:

Date (year):

Start

Finish

Location:

Institution:

Qualifications Obtained:

Class of Degree:

List the organizations for which you have worked and your positions within them.

Name of Company:

Position held:

Date (year):

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End

No. of employees:

Date (year):

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Name of Company:

Position held:

No. of employees:

Date (year):

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End

Name of Company:

Position held:

No. of employees:

Date (year):

Start

End

Name of Company:

Position held:

No. of employees:

List any professional bodies, associations, sports or social clubs, and voluntary organisations
of which you are a member

Name of Organisation:

Year joined:

Nature of Organisation:

Position held (if any):

Name of Organisation:

Year joined:

Nature of Organisation:

Position held (if any):

Which of the streams do you intend to study?

How did you first learn about the programme?

Thank you for your interest in our Masters programmes.

If you have not already done so, an administrative fee of N8,000 will need to be paid in order to process your application.

Please note also that all cheque/draft payment for the programme should be made in favour of School of Media and Communication or Bank transfer to any Guaranty Trust Bank branch into account number 214-774209-111.

Thank you.

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