| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P02120A | | SURNAME: | AWORERE | | OTHER NAMES: | JAEL ORIMISAN | | TITLE/GENDER: | MRS./F | | DATE OF BIRTH: | 1986-01-14 | | CHAPTER: | ONDO | | PHONE NUMBER: | 08071431809, | | EMAIL ADDRESS: | orisj4ever@yahoo.com | | POSTAL ADDRESS: | PHYSICAL PLANNING & DEVELOPMENT UNIT, ADEKUNLE AJASIN UNIVERSITY, AKUNGBA-AKOKO ONDO STATE | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2022-08-23 | | 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 | B3 | | MATHEMATICS | B3 | | PHYSICS | B3 | | CHEMISTRY | C6 | | ECONOMICS | 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, AKURE | NIGERIA | PGD IN QUANTITY SURVEYING | 2021-06-30 | | 2 | THE FEDERAL POLYTECHNIC, ADO-EKITI, EKITI STATE | NIGERIA | HND IN QUANTITY SURVEYING | 2015-04-30 |
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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 | SEPTEMBER 2025 | TPC/2025/01//R/72 | ABUJA | | 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 | ADEKUNLE AJASIN UNIVERSITY, AKUNGBA-AKOKO ONDO STATE | SENIOR TECHNICAL OFFICER (QUANTITY SURVEYOR) (2019-12-27 - Date) | COST MANAGEMENT AND CONTRACT ADMINISTRATION |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | ADEKUNLE AJASIN UNIVERSITY, AKUNGBA-AKOKO ONDO STATE | | b) EMPLOYER'S BUSINESS ADDRESS: | P.M.B. 01, AKUNGBA AKOKO, ONDO STATE, NIGERIA. | | c) NATURE OF EMPLOYER'S BUSINESS: | EDUCATION | | d) POSITION OF APPLICANT: | SENIOR TECHNICAL OFFICER (QUANTITY SURVEYOR) | | e) DATE OF EMPLOYMENT: | 2019-12-27 |
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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: | 02477 | | b) SPONSOR'S FULL NAME: | FADIYIMU AKINLOLU OYEBOBOLA | | c) SPONSOR'S EMAIL ADDRESS: | AKINLOLUFADIYIMU@GMAIL.COM | | d) SPONSOR'S CONTACT ADDRESS: | DIRECTORATE OF PHYSICAL PLANNING, FED UNIVERSITY OF TECH AKURE, ONDO STATE | | e) SPONSOR'S MEMBERSHIP GRADE: | FELLOW | | f) SPONSOR'S RESGISTRATION DATE:: | 2024-11-26 |
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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: | ONDO
| | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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PC59