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Title *

First Name*

Other Name*

Last Name*

Date of Birth (DOB) *

Gender
Male Female

Marital Status

MAIDEN NAME (IF APPLICABLE)

NUMBER OF CHILDREN & THEIR AGE (e.g 4, 10yrs, 7yrs, 5yrs & 2yrs)

NATIONALITY

GEO POLITICAL ZONE

SENATORIAL DISTRICT

STATE OF ORIGIN

LGA Of ORIGIN

RELIGION

PHYSICAL DISABILITY/CHALLENGE

NIN *

NEXT OF KIN INFORMATION

NAME OF NEXT OF KIN*

RELATIONSHIP WITH NEXT OF KIN*

TELEPHONE NO. OF NEXT OF KIN

ADDRESS OF NEXT OF KIN

EMPLOYMENT RECORDS

STAFF CATEGORY

DATE OF FIRST APPPOINTMENT

DESIGNATION AT FIRST APPPOINTMENT

STEP AT FIRST APPPOINTMENT

DATE OF CONFIRMATION OF APPPOINTMENT

DATE OF REGRADING/CONVERSION

DATE OF LAST PROMOTION

DATE OF PRESENT APPPOINTMENT*

PRESENT DESIGNATION

PRESENT GRADE LEVEL

PRESENT STEP

FACULTY/INSTITUTE/DIRECTORATE/CENTRES/REGISTRY/BURSARY

DEPARTMENT

UNIT/SECTION

STAFF UNION

QUALIFICATIONS

PROFESSIONAL ASSOCIATIONS (COREN, FCA, NUMN, NBA, ETC)

ID card Number

Personal File Number

CONTACT RECORDS

INSTITUTIONAL EMAIL ADDRESS*

OTHER EMAIL ADDRESS

MOBILE PHONE NUMBER*

OTHER PHONE NUMBER

MOBILE DATA NUMBER

ADDRESS OF RESIDENCE

PERMANENT HOME ADDRESS

SENATORIAL DISTRICT OF RESIDENCE

STATE OF RESIDENCE

LOCAL GOVERNMENT OF RESIDENCE

FINANCE RECORDS

SALARY STRUCTURE *

BANK NAME*

ACCOUNT NUMBER*

PENSION FUND ADMINISTRATOR*

PENCOM PIN NUMBER*

NHF NUMBER

NHIS NUMBER

TIN

IPPIS

OLD PAYSLIP NUMBER

OTHER DETAILS

Status

Access Level Position*

Password*

Retype Password*

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