| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00540M | | SURNAME: | MBAH | | OTHER NAMES: | DANIEL CHUKWUKA | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1993-09-28 | | CHAPTER: | ABUJA | | PHONE NUMBER: | 08149529109, | | EMAIL ADDRESS: | chukiembah@gmail.com | | POSTAL ADDRESS: | PLOT 1705 CADASTRAL ZONE A09, GUZAPE F.C.T ABUJA | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2023-08-08 | | 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 | C5 | | PHYSICS | C6 | | CHEMISTRY | C6 | | GEOGRAPHY | A1 |
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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 | 2017-12-20 | | 2 | FEDERAL POLYTECHNIC BIDA | NIGERIA | OND 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/2025/01/30 | 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 | MSHEL CONSTRUCTION LIMITED | SURVEYING MANAGER (2025-04-12 - Date) | OVERSEE THE SURVEYING DEPARTMENT WHICH COMPRISES OF THE QUANTITY SURVEYING UNIT AND THE LAND SURVEYING UNIT. | | 2 | DESIGN OASIS LIMITED | QUANTITY SURVEYOR (2021-02-10 - 2024-12-10) | PERFORMED QUANTITY SURVEYING DUTIES; PREPARATION OF COST ESTIMATES, COST CONTROL, VALUATION, PROJECT MANAGEMENT, ETC |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | MSHEL CONSTRUCTION LIMITED | | b) EMPLOYER'S BUSINESS ADDRESS: | PLOT 1705 CADASTRAL ZONE A09, GUZAPE F.C.T ABUJA | | c) NATURE OF EMPLOYER'S BUSINESS: | CONSTRUCTION COMPANY | | d) POSITION OF APPLICANT: | SURVEYING MANAGER | | e) DATE OF EMPLOYMENT: | 2025-04-12 |
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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: | 01971 | | b) SPONSOR'S FULL NAME: | ADEYEMO ADEBAYO SEGUN | | c) SPONSOR'S EMAIL ADDRESS: | ADEYEMOAS@GMAIL.COM | | d) SPONSOR'S CONTACT ADDRESS: | P. O. BOX 8654 WUSE ABUJA | | e) SPONSOR'S MEMBERSHIP GRADE: | MEMBER | | f) SPONSOR'S RESGISTRATION DATE:: | 2011-04-14 |
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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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PC69