International Student Application: Confirmation Number: 550070029 Date: 2014-Jan-20
International Student Application: Confirmation Number: 550070029 Date: 2014-Jan-20
Confirmation Number:
550070029
Date:
2014-Jan-20
NA
NO
Title
MR.
Surname/Family Name
USMAN
Given Name
ABUBAKAR
Gender
Male
Date of Birth
1978-Jun-03
Telephone
Home: 8061355891
Work: 0
Student/Applicant E-mail
Street/P.O.Box
City
KADUNA
Province/State
KADUNA STATE
Postal Code
800001
Country
NIGERIA
NO
Mobile: 8061355891
Ext.: 0
City
WARRI
Province/State
Postal Code
DELTA STATE
Country
NIGERIA
YES
Home: 0
Work: 0
Mobile:
Ext.: 0
Note that if you provide a contact name, you are giving permission for Seneca College to discuss all information related to
your application, acceptance or admission to the above named person.
-1-
550070029
Date:
2014-Jan-20
Section B. Citizenship
Country of citizenship
NIGERIA
Not Applicable
Completed
Documents:
To Follow
College/University:
Completed
Documents:
To Follow
Program Code
Start Date
Campus
Choice 1
CPD
May- 2014
SENECA@YORK
Choice 2
Choice 3
Section E. Declaration
I declare that the above information is true and complete. I understand that any false or incomplete information submitted in support of
my application may invalidate my application and result in mandatory withdrawal from Seneca College at any time during my enrollment.
Signature:
_______________________
-2-
Date:
_______________________
550070029
Date:
2014-Jan-20
Card type:
Name on the card:
Card Number ending with:
Expiry Date (MM/YYYY):
Card holder signature:
-3-
Master Card
Abubakar Usman
8871
10/2015
_____________________________________