| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00105I | | SURNAME: | AKINJAGUNLA | | OTHER NAMES: | CECILIA ALABA | | TITLE/GENDER: | MRS/F | | DATE OF BIRTH: | 1975-01-15 | | CHAPTER: | LAGOS | | PHONE NUMBER: | 08033892448, | | EMAIL ADDRESS: | cakinjagunla@gmail.com | | POSTAL ADDRESS: | P.O. BOX 15386 IKEJA LAGOS | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2003-12-16 | | 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 | C5 | | 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 POLYTECHNIC, ADO - EKITI, EKITI STATE | NIGERIA | HIGHER NATIONAL DIPLOMA IN QUANTITY SURVEYING | 2001-05-02 |
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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 2014 | TPC/2014/09/229 | YABATECH, LAGOS | | 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 | VITAL CONSTRUCTION LIMITED, OREGUN, LAGOS | QUANTITY SURVEYOR (2002-05-27 - Date) | PREPARATION OF BILLS OF QUANTITIES, PREPARATION OF SCHEDULE OF PROGRAMME |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | VIRAS LIMITED | | b) EMPLOYER'S BUSINESS ADDRESS: | 11, ALLEN AVENUE, IKEJA, LAGOS | | c) NATURE OF EMPLOYER'S BUSINESS: | BUILDING CONSTRUCTION | | d) POSITION OF APPLICANT: | QUANTITY SURVEYOR | | e) DATE OF EMPLOYMENT: | 2002-05-28 |
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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: | 01786 | | b) SPONSOR'S FULL NAME: | FALUSI OLUFEMI ODUNITAN | | c) SPONSOR'S EMAIL ADDRESS: | KOSTKONCIOUS@YAHOO.CO.UK | | d) SPONSOR'S CONTACT ADDRESS: | P. O. BOX 432 SOMOLU, LAGOS | | e) SPONSOR'S MEMBERSHIP GRADE: | FELLOW | | f) SPONSOR'S RESGISTRATION DATE:: | 2021-11-16 |
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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: | LAGOS
| | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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PC70