| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00271U | | SURNAME: | USMAN | | OTHER NAMES: | NURUDDEEN | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1992-09-26 | | CHAPTER: | KANO | | PHONE NUMBER: | 07034977586, | | EMAIL ADDRESS: | nuruddeen666@gmail.com | | POSTAL ADDRESS: | KANO STATE | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2021-10-12 | | 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 | C4 | | MATHEMATICS | C5 | | PHYSICS | C6 | | CHEMISTRY | C6 | | ECONOMICS | C6 |
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| 4.0 EDUCATION: |
| SN | UNIVERSITY/INSTITUTION | COUNTRY | DEGREE/DIPLOMA NAME
(eg. B.Tech Quantity Surveying) | DATE COMPLETED | | 1 | ABUBAKAR TAFAWA BALEWA UNIVERSITY | NIGERIA | B.TECH IN QUANTITY SURVEYING | 2018-02-01 |
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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 | JULY 2025 | TPC/2025/06/R/135 | KANO | | 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 | PROACTIVE CONSTRUCTION SERVICE LIMITED | QS / PROCUREMENT OFFICER (2022-01-05 - Date) | PROCUREMENT AND PROJECT MANAGEMENT |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | PROACTIVE CONSTRUCTION SERVICE LIMITED | | b) EMPLOYER'S BUSINESS ADDRESS: | AB 167 SHEHU KAZAURE ROAD, HOTORO GRA KANO | | c) NATURE OF EMPLOYER'S BUSINESS: | CONSTRUCTION / CONSULTANCY/ PROJECT MANAGEMENT | | d) POSITION OF APPLICANT: | QS / PROCUREMENT OFFICER | | e) DATE OF EMPLOYMENT: | 2022-01-05 |
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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: | 04266 | | b) SPONSOR'S FULL NAME: | MUSA BABA ABUBAKAR | | c) SPONSOR'S EMAIL ADDRESS: | BABAABUBAKAR008@GMAIL.COM | | d) SPONSOR'S CONTACT ADDRESS: | NO 114, HOTORO QUARTERS NASSARAWA,KANO STATE. | | 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: | KANO
| | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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