| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P01907A | | SURNAME: | AJIBULU | | OTHER NAMES: | MONDAY ILESANMI | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1989-07-14 | | CHAPTER: | ABUJA | | PHONE NUMBER: | 08067659892, | | EMAIL ADDRESS: | princeajibulu14@gmail.com | | POSTAL ADDRESS: | NO. 13 BEN IROKO STRT BEHIND VAWA BAKERY SHARP CORNER, MARABA | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2021-02-12 | | 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 | C5 | | CHEMISTRY | C4 | | 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 | BTECH IN QUANTITY SURVEYING | 2012-12-20 |
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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/2025/01/05 | ABUJA | | LOGBOOK/DIARY STAGE 3 | JULY 2023 | | |
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| 7.0 PROFESSIONAL EXPERIENCE: |
| SN | EMPLOYER'S NAME AND ADDRESS | POSITION HELD & DATES | DUTIES | | 1 | H O S | RESIDENCE QUANTITY SURVEYOR (2026-03-03 - 2026-03-26) | BILL PREPARATION, VALUATION OF WORKS MATERIALS AND LABOUR SCHEDULE |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | HOS | | b) EMPLOYER'S BUSINESS ADDRESS: | REVENUE HOUSE, FCT ABUJA | | c) NATURE OF EMPLOYER'S BUSINESS: | CONSULTANCY | | d) POSITION OF APPLICANT: | CONSULTANT | | e) DATE OF EMPLOYMENT: | 2024-10-01 |
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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: | 05389 | | b) SPONSOR'S FULL NAME: | SANI HAUWA TSWAKO | | c) SPONSOR'S EMAIL ADDRESS: | HAUWATSWAKO22@GMAIL.COM | | d) SPONSOR'S CONTACT ADDRESS: | NO. 8, MN OYAWOYE CLOSE, LIFE CAMP, ABUJA. | | e) SPONSOR'S MEMBERSHIP GRADE: | MEMBER | | f) SPONSOR'S RESGISTRATION DATE:: | 2022-08-23 |
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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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PC55