| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00338B | | SURNAME: | BAKO | | OTHER NAMES: | PHILEMON | | TITLE/GENDER: | MR /M | | DATE OF BIRTH: | 1982-12-18 | | CHAPTER: | NIGER | | PHONE NUMBER: | 07069430053, | | EMAIL ADDRESS: | bakophilemon04@gmail.com | | POSTAL ADDRESS: | UPPER NIGER RIVER BASIN DEV. AUTHORITY, KM5 P.M.B. 68, MINNA-NIGER STATE | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2021-10-12 | | 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 | C6 | | MATHEMATICS | C6 | | PHYSICS | C6 | | CHEMISTRY | C6 | | BIOLOGY | C6 |
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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 | NIGERIA | PGD(QS) IN QUANTITY SURVEYING | 2016-03-30 | | 2 | FEDERAL POLYTECHNIC NASARAWA | NIGERIA | HND IN QUANTITY SURVEYING | 2007-08-29 | | 3 | FEDERAL POLYTECHNIC NASARAWA | NIGERIA | ND IN QUANTITY SURVEYING | 2001-10-30 |
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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/2025/01/13 | ABUJA | | LOGBOOK/DIARY STAGE 3 | JUNE 2024 | | |
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| 7.0 PROFESSIONAL EXPERIENCE: |
| SN | EMPLOYER'S NAME AND ADDRESS | POSITION HELD & DATES | DUTIES | | 1 | UPPER NIGER RIVER BASIN DEVELOPMENT AUTHORITY | PRINCIPAL TECHNICAL OFFICER (QS II) (2016-12-29 - Date) | SITE MEASUREMENT AND VALUATION |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | UPPER NIGER RIVER BASIN DEVELOPMENT AUTHORITY | | b) EMPLOYER'S BUSINESS ADDRESS: | KM5 P.M.B 68, MINNA-NIGER STATE NIGERIA | | c) NATURE OF EMPLOYER'S BUSINESS: | FEDERAL MINISTRY OF WATER RESOURCE | | d) POSITION OF APPLICANT: | MANAGING DIRECTOR | | e) DATE OF EMPLOYMENT: | 2012-11-29 |
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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: | 01761 | | b) SPONSOR'S FULL NAME: | BISSALLA FREDERICK TIVU PHILIP | | c) SPONSOR'S EMAIL ADDRESS: | BISSALLA08@YAHOO.COM | | d) SPONSOR'S CONTACT ADDRESS: | FED. MIN. OF WORKS & HOUSING PUBLIC BUILDING & HOUSING DEPT HQ, MABUCHI ABUJA | | e) SPONSOR'S MEMBERSHIP GRADE: | FELLOW | | f) SPONSOR'S RESGISTRATION DATE:: | 2020-11-11 |
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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: | NIGER
| | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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PC48