Admission Application | Adaklu Senior High School
Jim Bourton Memorial Agricultural SHS, Logba (JIBMASS)
Admission Application Form
"PATIENCE AND PERSEVERANCE"
Step 1 of 3: Personal Information
Admission Details
Admission Form
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ACADEMIC INFO
Index Number
*
Enter the index number including 25
Enrolment Code
*
Format: ENRHB22X5. Check on Placement Form
Name of Student
*
Gender
*
Programme
*
Status
*
Track
*
Date of Enrolment
*
Admission Number
Admission Type
Auto Placement
Protocol Placement
Re-Entry Request
Year of Completion
2024
2023
2022
2021
JHS Type
*
Public JHS
Private JHS
House Assigned
PERSONAL INFO
Date of Birth
*
Age
*
Place of Birth
*
Home Town
*
Region
*
Ahafo
Ashanti
Bono
Bono East
Central
Eastern
G. Accra
North East
Northern
Oti
Savannah
Upper East
Upper West
Volta
Western
Western North
District
*
Religion
*
Christian
Islamic
Traditional
Phone Number
Ghana Card Number
MEDICAL RECORDS
NHIS Number
Any Medical Condition
*
Yes
No
Conditions
Ulcer
Migraine (Severe Headache)
Rheumatism
Asthma
Sickle Cell
Other
Other Conditions
Medical Report (Optional)
Drop a file here or click to upload
Choose File
Maximum file size: 516MB
PARENT/GUARDIAN INFO
Parent Name
*
Gender
Male
Female
Relationship
*
Father
Mother
Guardian
Phone
*
Email
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