| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00508S | | SURNAME: | SAMUEL | | OTHER NAMES: | SUNDAY OSAYI | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1987-03-29 | | CHAPTER: | ABUJA | | PHONE NUMBER: | 08060041501, | | EMAIL ADDRESS: | peco8813@gmail.com | | POSTAL ADDRESS: | HOUSE 10, Q CLOSE, 5TH AVENUE, FESTAC, LAGOS. | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2023-07-19 | | 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 | C6 | | MATHEMATICS | C4 | | PHYSICS | C5 | | ECONOMICS | C6 | | GEOGRAPHY | 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 | B.TECH IN QUANTITY SURVEYING | 2014-05-28 | | 2 | FEDERAL UNIVERSITY OF TECHNOLOGY, MINNA | NIGERIA | M.TECH IN QUANTITY SURVEYING | 2022-12-08 |
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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/2025/01/43 | 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 | BMO REAL ESTATE CONSTRUCTION LTD | QUANTITY SURVEYOR/PROJECT MANAGER (2015-10-15 - 2023-02-28) | PREPARATION OF BOQ, PREPARATION OF CLAIMS, MARKETING SURVEY, NEGOTIATING WITH SUBCONTRACTORS, MANAGING OF CONSTRUCTION ACTIVITIES ON SITE. | | 2 | NIGERIAN PORTS AUTHORITY | QUANTITY SURVEYOR II (2023-03-27 - Date) | PREPARATION OF BOQ, MARKET SURVEY, REVIEWING OF RATES, PREPARATION OF VALUATION CERTIFICATES, REVIEWING AND VETTING OF SUBMITTED BOQS |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | NIGERIAN PORTS AUTHORITY | | b) EMPLOYER'S BUSINESS ADDRESS: | 26/28 MARINA ROAD, LAGOS ISLAND, LAGOS | | c) NATURE OF EMPLOYER'S BUSINESS: | PROVISION OF PORTS INFRASTRUCTURES AND SERVICES | | d) POSITION OF APPLICANT: | QUANTITY SURVEYOR II | | e) DATE OF EMPLOYMENT: | 2023-01-11 |
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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: | 04101 | | b) SPONSOR'S FULL NAME: | USMAN NASIR DANKYARANA | | c) SPONSOR'S EMAIL ADDRESS: | ELNAS_OTHMAN@YAHOO.COM | | d) SPONSOR'S CONTACT ADDRESS: | ENGINEERING DEPARTMENT, NIGERIAN PORT AUTHORITY, HOUSE 26/28 MARINA, LAGOS. | | e) SPONSOR'S MEMBERSHIP GRADE: | MEMBER | | f) SPONSOR'S RESGISTRATION DATE:: | 2018-09-19 |
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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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PC51