| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00290E | | SURNAME: | EMMANUEL | | OTHER NAMES: | TIMOTHY BAMIDELE | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1990-09-25 | | CHAPTER: | LAGOS | | PHONE NUMBER: | 07061812722, | | EMAIL ADDRESS: | emmanueltim50@gmail.com | | POSTAL ADDRESS: | 9 IRETI OLUWA STREET, LAGOS | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2019-02-04 | | DIET: | MARCH, 2026 | | DISABILITY: | NO |
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| 2.0 PREFERRED INTERVIEW CENTRE: |
| LAGOS |
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| 3.0 O' LEVEL SUBJECTS RESULT (5 CREDITS FROM WAEC/NECO/NABTEB): |
| SUBJECTS | GRADE | | ENGLISH | C5 | | MATHEMATICS | C4 | | PHYSICS | B3 | | CHEMISTRY | C5 | | GEOGRAPHY | A1 |
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| 4.0 EDUCATION: |
| SN | UNIVERSITY/INSTITUTION | COUNTRY | DEGREE/DIPLOMA NAME
(eg. B.Tech Quantity Surveying) | DATE COMPLETED | | 1 | FEDERAL POLYTECHNIC NASARAWA | NIGERIA | OND/HND IN QUANTITY SURVEYING | 2012-01-19 |
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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 | SEPTEMBER 2025 | TPC2/2025/02/100 | LAGOS | | LOGBOOK/DIARY STAGE 3 | JULY 2025 | | |
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| 7.0 PROFESSIONAL EXPERIENCE: |
| SN | EMPLOYER'S NAME AND ADDRESS | POSITION HELD & DATES | DUTIES | | 1 | GATON AFRICA LIMITED /WING B MOTOR WAYS OREGUN IKEJA | QUANTITY SURVEYOR (2018-08-21 - Date) | PREPARATION BOQ, PRICING OF TENDER, PREPARATION OF VALUATION AND VARIATION ORDER |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | GATON AFRICA LIMITED /WING B MOTOR WAYS OREGUN IKEJA | | b) EMPLOYER'S BUSINESS ADDRESS: | CARLOS@GATON.ES | | c) NATURE OF EMPLOYER'S BUSINESS: | CONSTRUCTION COMPANY | | d) POSITION OF APPLICANT: | MANAGING DIRECTOR | | e) DATE OF EMPLOYMENT: | 2018-08-21 |
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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: | 03832 | | b) SPONSOR'S FULL NAME: | AJETOMOBI ADEDOYIN VICTOR | | c) SPONSOR'S EMAIL ADDRESS: | AJETOMOBIADEDOYIN@YAHOO.COM | | d) SPONSOR'S CONTACT ADDRESS: | APATA STREET, SHOMOLU | | e) SPONSOR'S MEMBERSHIP GRADE: | MEMBER | | f) SPONSOR'S RESGISTRATION DATE:: | 2017-07-04 |
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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: | LAGOS
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| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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PC4