AES - 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.

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

MEMBERSHIP APPLICATION FORM

PERSONAL DETAILS
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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