Personal Information
Student Name
*
First (Tiv) Name
Middle (English) Name
Last Name (Surname)
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
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22
23
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25
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28
29
30
31
Day
Please select a year
2025
2024
2023
2022
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2020
2019
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2014
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2012
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2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
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1958
1957
1956
1955
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1953
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1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Gender
*
Please Select
Male
Female
N/A
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Mobile Number 1
*
Mobile Number 2
State of Origin
*
Please Select
Benue State
Nasarawa State
Taraba State
Local Government Area
*
Please Select
Buruku
Gboko
Guma
Gwer East
Gwer West
Katsina-Ala
Konshisha
Kwande
Logo
Makurdi
Tarka
Ukum
Ushongo
Vandeikya
Nasarawa State Indigene
Plateau State Indigene
Taraba State Indigene
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Educational Information
Name of School or University
*
Department
*
Course of Study
*
Year of Entry
*
Expected Graduation Date
*
Current Level
*
CGPA
*
Number of semesters used to calculate the CGPA
*
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Document Upload
Please upload the supporting documents
Personal Statement
*
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Student Information Verification
*
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State or Local Government of Origin
*
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Letter of Recommendation or any other supporting document
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Attestation
Have you ever received MUTA award?
Yes
No
Are you a member of any cult organization?
Yes
No
Have you ever been convicted of a crime?
Yes
No
Signature
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