AES - Membership Application Form

MEMBERSHIP APPLICATION FORM

Guidelines for Completing the AES Membership Form

1. Fill the form below and submit online.
2. Pay the mandatory N50,000.00 registration fee into the Academy's bank account:

Bank Name - Zenith Bank Plc.

A/C Name - Academy for Entrepreneurial Studies Nigeria.

A/C Number- 621390-1582

3. Forward Photocopy of Bank Teller along with the following documents:

(a) Photocopies of Certificate(s) or Statement(s) of result(s).

(b) Birth certificate or sworn declaration of age.

(c) Two recent passport size photographs.

To: The Registrar
      Academy for Entrepreneurial Studies, Nigeria.
      Marble House 17 Alhaji Bashorun Street
      off Norman Williams Street,
      off Awolowo Road,
      Ikoyi Lagos.

APPLICATION FORM



	SECRETARIAT: Marble House 17 Alhaji Bashorun Street, Off Norman Williams Street, off Awolowo Road, Ikoyi Lagos.	Tel: 01-7642280, 01-4749949, Mobile: 0806 283 9882, 08074049317, 07023261763 E-mail: info@aes-edu.net, aes_nig@yahoo.com

1 (a) Surname*:		(b) Other name(s)*
2. Tittle :	Dr. Mr. Miss. Mrs. Other
2a. Date of Birth*:	Year: Age
3. Sex*:	Male Female
4. Place of Birth:
5.Address for Correspondence (Please, write in BLOCK LETTERS)
Telephone No(s):*	Email:*
6. (a) Nationality:*	(b). State of Origin:
(c) Local Government Area:
(d) Town / Village
(e) Religion:*
7 (a) Name and Address of next of Kin*
Telephone No(s)	Email:
(b) Relationship:
8. Present Employment:*
EDUCATIONAL QUALIFICATION(S)
(9a) School(s) Attended: *
(9b) Qualification(s) obtained:*
(9c) Discipline:*
(9d) Other Information (if any)
PERSONAL DETAILS
(a) Bank Name*
(b) Branch *
(c) Amount *
(d) Teller No*
(e) Depositor's Name*
(f) Date*
DECLARATION
I declare that the statements made by me on this form are true to the best of my knowledge and belief, true and correct as I may be disqualified for any falsehood.
True False Date*

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