| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00367E | | SURNAME: | EMAIKWU | | OTHER NAMES: | SAMUEL UGBOHA | | TITLE/GENDER: | MR./M | | DATE OF BIRTH: | 1994-12-14 | | CHAPTER: | ABUJA | | PHONE NUMBER: | 08063247810, | | EMAIL ADDRESS: | emaikwusam@gmail.com | | POSTAL ADDRESS: | NIGERIA DEFENCE HEADQUARTERS, ENGINEERING DEPARTMENT ABUJA | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2023-07-05 | | 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 | C4 | | MATHEMATICS | C6 | | PHYSICS | C4 | | ECONOMICS | C5 | | GEOGRAPHY | B3 |
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| 4.0 EDUCATION: |
| SN | UNIVERSITY/INSTITUTION | COUNTRY | DEGREE/DIPLOMA NAME
(eg. B.Tech Quantity Surveying) | DATE COMPLETED | | 1 | FEDERAL UNIVERSITY OF TECHNOLOGY MINNA | NIGERIA | B. TECH IN QUANTITY SURVEYING | 2019-12-11 |
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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 2026 | TPC/2025/01/19 | ABUJA | | 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 | NIGERIA DEFENCE HEADQUARTERS, GARKI AREA 7, ABUJA | QUANTITY SURVEYING ASSISTANCE (2024-03-31 - Date) | PREPARE BILLS OF QUANTITIES, MANAGE AND SUPERVISE CONSTRUCTION WORK EXECUTED | | 2 | MOXIE ALLIANCE LIMITED, EMMANUEL PLAZA JABI ABUJA | QUANTITY SURVEYING ASSISTANCE (2023-05-08 - 2024-01-04) | PREPARE BILLS OF QUANTITIES, MANAGE AND SUPERVISE CONSTRUCTION WORKS EXECUTED |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | NIGERIA DEFENCE HEADQUARTERS | | b) EMPLOYER'S BUSINESS ADDRESS: | NIGERIA DEFENCE HEADQUARTERS, ENGINEERING DEPARTMENT ABUJA, GARKI AREA 7, ABUJA | | c) NATURE OF EMPLOYER'S BUSINESS: | CIVIL ENGINEERING PROJECTS, BUILDING CONSTRUCTION WORK | | d) POSITION OF APPLICANT: | QUANTITY SURVEYING | | e) DATE OF EMPLOYMENT: | 2024-03-31 |
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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: | 04775 | | b) SPONSOR'S FULL NAME: | KADI OLABANJI MICHEAL | | c) SPONSOR'S EMAIL ADDRESS: | MIKEOLABANJI@GMAIL.COM | | d) SPONSOR'S CONTACT ADDRESS: | RCCG MOUNT ZION PARISH, P. O. BOX 4655, GARKI-ABUJA. | | e) SPONSOR'S MEMBERSHIP GRADE: | FELLOW | | f) SPONSOR'S RESGISTRATION DATE:: | 2025-11-13 |
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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: | ABUJA
| | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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