Fill the BIO – DATA form Section A — PERSONAL INFORMATIONFirst Name *Date of Birth *Surname *Gender *MaleFemaleHome address *full address including stateEmail Address *Personal phone number (Primary) *Second personal phone number (if any) Section B — PROGRAMME DETAILSSelect your Category *SIWESNYSCDirect InternName of institution (Compulsory for SIWES & NYSC)Placement State Date *Placement End Date *Discipline / Course of Study (Compulsory for SIWES & NYSC)How did you hear about us? *Google SearchFacebookInstagramLinkedInChatGPTWhatsAppReferral from a Friend/ColleagueGeminiNYSC/SIWES RecommendationSchool/Institution RecommendationOnline AdvertisementOther (Please specify)Select all applicable optionsSection C — EMERGENCY CONTACT (Parent/Guardian))Parent/Guardian Full name *Relationship to you *Primary Phone Number *Secondary Phone Number Occupation *Section D — HEALTH & SPECIAL NEEDSAny medical condition DuraTech Multi-Solutions should be aware of *Any medication being taken regularly? *Any physical or accessibility needs *Blood group (optional) (optional but useful in emergencies)Section E — BACKGROUND CHECK CONSENT & DECLARATION. *I hereby consent to DuraTech Multi-Solutions contacting the parent or guardian named in this form for the purpose of verifying my placement details and confirming their awareness of my participation in the DMS Launchpad Programme. I understand that this call is a standard part of DuraTech's participant onboarding process.. *I confirm that the parent or guardian named in Section C of this form is fully aware that I have applied for and been accepted into the DMS Launchpad Programme at DuraTech Multi-Solutions, Ibadan, and has given their consent for me to participate.. *I confirm that all information provided above is accurate and complete. *I understand that providing false information may result in immediate termination of placementMessageSUBMIT BIO-DATA FORM
