Apply for 2015 Bursary

Application form for 2015 Prof. Ajibefun bursary form is out. An eligible Student of Okunmo can obtain this form at FOSA Secretariat.

PERSONAL DATA:
1. NAME:……………………………………….
2. SCHOOL:……………………………………
3. MATRIC NO:……………………………….
4. COURSE:…………………………………….
5. TOWN:……………………………………….
6. LOCAL GOVERNMENT:…………………
7. STATE OF ORIGIN:………………………
8. EMAIL ADD:……………………………….
9. PHONE NUMBER:……………………….
10. CGPA:…………………………………….

BANK DETAILS:
Bank name:…………………………………..
Account name:……………………………….
Account number:…………………………….

OFFICIAL USE ONLY
I recommend ………………………………….as bonafide member of FOSA and has perform his/her responsibility to the association and the community.

………………. ………………………
FOSA SEC. FOSA PRESIDENT
Sign/Date. Sign/Date

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