| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00255N | | SURNAME: | NZAGHA | | OTHER NAMES: | CHUKWUCHI EZE | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1987-10-12 | | CHAPTER: | EBONYI | | PHONE NUMBER: | 08163294391, | | EMAIL ADDRESS: | chukwuchiezenzagha@gmail.com | | POSTAL ADDRESS: | AMACHI NDUKWE AMASIRI AFIKPO, NORTH, EBONYI STATE | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2024-01-18 | | DIET: | MARCH, 2026 | | DISABILITY: | NO |
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| 2.0 PREFERRED INTERVIEW CENTRE: |
| ABUJA |
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| 3.0 O' LEVEL SUBJECTS RESULT (5 CREDITS FROM WAEC/NECO/NABTEB): |
| SUBJECTS | GRADE | | ENGLISH | C5 | | MATHEMATICS | C5 | | PHYSICS | C4 | | ECONOMICS | C5 | | CHEMISTRY | C6 |
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| 4.0 EDUCATION: |
| SN | UNIVERSITY/INSTITUTION | COUNTRY | DEGREE/DIPLOMA NAME
(eg. B.Tech Quantity Surveying) | DATE COMPLETED | | 1 | AKANU IBIAM FEDERAL POLYTECHNIC UNWANA | NIGERIAN | HND IN QUANTITY SURVEYING | 2015-01-23 |
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| 5.0 MEMBERSHIP OF ANY OTHER PROFESSIONAL INSTITUTION(S): (IF ANY) |
| SN | NAME OF INSTITUTION | CURRENT GRADE | HOW MEMBERSHIP WAS ACHIEVED
(E.G. EXAMINATION) | YEAR REGISTERED/
OBTAINED/ELECTED |
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| 6.0 PATICULARS OF TPC EXAMINATION AND LOGBOOK/DIARY STAGE 3 PASSED (OR RICS MEMBERSHIP) |
| DETAILS | YEAR/MONTH | EXAM. NO.
(WHERE APPLICABLE) | CENTER
(WHERE APPLICABLE) | | TPC EXAMINATION | MAY 2025 | TPC/2025/03/78 | ENUGU STATE CENTRE | | LOGBOOK/DIARY STAGE 3 | FEBRUARY 2026 | | |
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| 7.0 PROFESSIONAL EXPERIENCE: |
| SN | EMPLOYER'S NAME AND ADDRESS | POSITION HELD & DATES | DUTIES | | 1 | DAVID UMAHI FEDERAL UNIVERSITY OF HEALTH SCIENCES UBURU | SENIOR TECHNICAL OFFICER (2022-01-03 - Date) | 1.PREPARATION OF BOQ, 2 . PREPARATION OF TENDER DOCUMENTS, 3 TENDER ANALYSIS, PREPARATION OF INTERIM VALUATION, FINAL ACCOUNT ETC | | 2 | CATAFY GLOBAL COMPANY WHITE MAN COMPANY ENUGU OPPOSITE CENTENARY CITY | QUANTITY SURVEYOR (2022-01-03 - 2022-11-02) | 1.PREPARATION OF BOQ, 2 . PREPARATION OF TENDER DOCUMENTS, 3 TENDER ANALYSIS, PREPARATION OF INTERIM VALUATION, FINAL ACCOUNT, PREPARATION OF SITE MEETINGS REPORT ETC |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | DAVID UMAHI FEDERAL UNIVERSITY OF HEALTH SCIENCES UBURU | | b) EMPLOYER'S BUSINESS ADDRESS: | OHAOZARA LOCAL GOVERNMENT EBONYI STATE, IN UMUNAGA UBURU | | c) NATURE OF EMPLOYER'S BUSINESS: | UNIVERSITY | | d) POSITION OF APPLICANT: | QS | | e) DATE OF EMPLOYMENT: | 2021-08-08 |
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| f) I hereby attest that to the best of my knowledge, the particulars given by me and the applicant here are true and correct. |
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EMPLOYER'S SIGNATURE & DATE |
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| 9.0 SPONSOR DETAILS |
| a) SPONSOR'S NIQS MEMBERSHIP NUMBER: | 01835 | | b) SPONSOR'S FULL NAME: | OGBONNA JOHN NDUBUISI | | c) SPONSOR'S EMAIL ADDRESS: | NDJOHNNY@YAHOO.COM | | d) SPONSOR'S CONTACT ADDRESS: | DAVID UMAHI FEDERAL UNIVERSITY OF HEALTH SCIENCES , UBURU EBONYI STATE | | e) SPONSOR'S MEMBERSHIP GRADE: | FELLOW | | f) SPONSOR'S RESGISTRATION DATE:: | 2019-11-18 |
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| g) I hereby declare that to the best of my knowledge, the particulars given by me and the applicant here are true and correct. |
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SPONSOR'S SIGNATURE & DATE |
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| 10.0 APPLICANT'S DECLARATION |
I declare that the particulars given on this form are true and correct and that I will abide by the Rules and Regulations governing the Institute’s Examinations.
By completing and submitting this application form, you agree to be bound by all existing NIQS Examination Policies, Rules and Guidelines and the rules guiding the MARCH, 2026 professional examination in particular.
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| Applicant's Signature.......................................................................... Date.............................................. |
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| 11.0 STATE CHAPTER CHAIRMAN/SECRETARY (COMPULSORY) TO BE COMPLETED MANUALLY |
| CHAPTER: | EBONYI
| | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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