EMBA APPLICATION
*Form Completion Guide

Surname: Firstname: Others: Name you will like to be called:
Sex: Nationality:
Marital Status:
Date of Birth: Day Month Year
Spouse's Name: Number of Children: Ages: Home Address: Telephone example format: 2348070000000: Hobbies: Email: Choose Password: Re-type Password:

Passport Photograph: (! picture file size should be less than 250kb)

Religion: Islam Anglican Methodist Roman Catholic Other Christian Others

Company Name: Nature of business: Company’s turnover: No. of employees: Business address:

Company's telephone: Company's fax: Mailing Address (if different from above):

Job title:

1. List below your academic history, including secondary and higher education.
A. institution: Location: Period ( from - to ): Title, field and class of degree:

 


Number of subject passed in O’Level (minimum of C grade):
Grade in English in O’Level:
Grade in Mathematics in O’level:

 


B. institution: Location: Period ( from - to ): Title, field and class of degree:

 


University – Class of degree:

 

C. institution: Location: Period ( from - to ): Title, field and class of degree:

 

D. institution: Location: Period ( from - to ): Title, field and class of degree:

 

E. institution: Location: Period ( from - to ): Title, field and class of degree:

 

Date NYSC started (D-M-Y): Day Month Year
Date NYSC ended (D-M-Y): Day Month Year

 

2. List below other formal academic courses, post graduate work or management programmes (of at least 3 weeks duration) which you have participated in

A. Course / Workshop title: Duration: Institution/ organisation: Location:

 

B. Course / Workshop title: Duration: Institution/ Organisation: Location:

 

C. Course / Workshop title: Duration: Institution/ Organisation: Location:

 

D. Course / Workshop title: Duration: Institution/ Organisation: Location:

 

E. Course / Workshop title: Duration: Institution/ Organisation: Location:

GMAT test date: GMAT Total Score:

WORKING EXPERIENCE

List chronologically the organizations for which you have worked and your positions within them, including your present one. Also enclose your curriculum vitae.

A. company Name: Position held: Period: MM/YY - MM/YY: No. of employees:

 

B. company Name: Position held: Period: MM/YY - MM/YY: No. of employees:

 

C. company Name: Position held: Period: MM/YY - MM/YY: No. of employees:

 

D. company Name: Position held: Period: MM/YY - MM/YY: No. of employees:

 

E. company Name: Position held: Period: MM/YY - MM/YY: : No. of employees:

 

A. Name of organization: Position held if any: Year joined: Nature of organization:

 

B. Name of organization: Position held if any: Year joined: Nature of organization:

 

C. Name of organization: Position held if any: Year joined: Nature of organization:

 

D. Name of organization: Position held if any: Year joined: Nature of organization:

 

E. Name of organization: organisation5_position_held: Position held if any: Nature of organization:

Please frankly comment about

1. Your personality:

2. Any ethical dilemma you have experienced and your solution to it:

3. Any significant achievement and a failure in your professional, academic and social life:

Your CV: (! file size should be less than 400kb and in either MSWORD or PDF format)

Upload the organogram of your organization, showing your own post clearly labeled, as well as other principal managers: (! file size should be less than 400kb and in either MSWORD or PDF format)


 

Reference forms (! Click to Download)


Telephone234-(0)1-8991449, 234-(0)1-7740280 SchoolKm 22 Lekki - Epe Expressway Ajah, Lagos, Nigeria.
©2010 Lagos Business School (LBS) * Pan-African University