## Lagos State Private Institution - Annual Renewal Fee Form ##

ANNUAL RENEWAL FEE FORM

Name of Institution:

Institution Reference Number:

Contact Address/Location:

Local Government Area:

Type of Institution:

Nursery Primary Junior Secondary
Senior Secondary Vocational/Remedial

Type of Structure:

Annual Renewal Fee paid Previous Year:

Evidence of Payment - (Receipt Number):

Head of School

Last Name:

Other Name:

First Name:

School Phone Number:

E-mail Address:

Proprietor of School

Last Name of Proprietor:

Other Name of Proprietor:

first Name of Proprietor:

Proprietor Qualification:

Number of Classrooms:

Year founded/ Established:

Year of Approval:

School Population

Number of Boys:

Number of Girls:

Staff Population - Teaching

Number of Males:

Number of Females:

Staff Population - Non-Teaching

Number of Males:

Number of Females:

Type of Structure:

Date of Last Inspection visit to School: