| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00416S | | SURNAME: | SAMUEL | | OTHER NAMES: | ABOSEDE OLUWATOYIN | | TITLE/GENDER: | MRS./FEMALE | | DATE OF BIRTH: | 1983-05-01 | | CHAPTER: | OYO | | PHONE NUMBER: | 09065997532, | | EMAIL ADDRESS: | bosedeoluwatoyin6@gmail.com | | POSTAL ADDRESS: | NO 12, OYELESE STREET, IKOLABA ESTATE, IBADAN. | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2020-08-13 | | DIET: | MARCH, 2026 | | DISABILITY: | NO |
|
| |
| 2.0 PREFERRED INTERVIEW CENTRE: |
| LAGOS |
| |
| 3.0 O' LEVEL SUBJECTS RESULT (5 CREDITS FROM WAEC/NECO/NABTEB): |
| SUBJECTS | GRADE | | ENGLISH | C6 | | MATHEMATICS | C6 | | PHYSICS | C6 | | CHEMISTRY | B3 | | AGRIC SICENCE | B3 |
|
| |
| 4.0 EDUCATION: |
| SN | UNIVERSITY/INSTITUTION | COUNTRY | DEGREE/DIPLOMA NAME (eg. B.Tech Quantity Surveying) | DATE COMPLETED | | 1 | OBAFEMI AWOLOWO UNIVERSITY ILE-IFE | NIGERIA | BSC. IN QUANTITY SURVEYING | 2010-12-17 | | 2 | THE FEDERAL POLYTECHNIC EDE, OSUN STATE. | NIGERIA | OND IN QUANTITY SURVEYING | 2005-12-16 |
|
| |
| 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 | | 1 | INTERNATIONAL PROJECT MANAGEMENT PROFESSIONALS | CERTIFIED PROJECT MANAGER | EXAMINATION | 2012 |
|
| |
| 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 | TPC2/2025/02/124 | LAGOS | | LOGBOOK/DIARY STAGE 3 | JULY 2025 | | |
|
| |
| 7.0 PROFESSIONAL EXPERIENCE: |
| SN | EMPLOYER'S NAME AND ADDRESS | POSITION HELD & DATES | DUTIES | | 1 | SITE MANAGEMENT CONSULTANTS LTD, 1ST FLOOR, BANK OF AGRICULTURE, TOTAL GARDEN, IBADAN. | QUANTITY SURVEYOR (2026-01-05 - Date) | OFFICE AND FIELD WORK | | 2 | FAX CONSULT LTD, BODIJA, IBADAN. | QUANTITY SURVEYOR (2022-11-14 - 2025-02-28) | OFFICE AND FIELD WORK | | 3 | AKINJO & PARTNERS, OFF HOLY TRINITY SCHOOL, OLD IFE ROAD, IBADAN. | QUANTITY SURVEYOR (2021-06-21 - 2021-10-28) | OFFICE WORK | | 4 | QUANTEC CONSULTANTS, SPACCO HOUSE, LIBERTY ROAD, IBADAN. | QUANTITY SURVEYOR (2018-12-03 - 2020-12-18) | OFFICE AND FIELD WORK |
|
| |
| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | AFE ADEDEJI PETER | | b) EMPLOYER'S BUSINESS ADDRESS: | 1ST FLOOR, BANK OF AGRICULTURE, TOTAL GARDEN IBADAN. | | c) NATURE OF EMPLOYER'S BUSINESS: | CONSULTANCY | | d) POSITION OF APPLICANT: | QUANTITY SURVEYOR | | e) DATE OF EMPLOYMENT: | 2026-01-05 |
|
| |
| f) I hereby attest that to the best of my knowledge, the particulars given by me and the applicant here are true and correct. |
| |
 EMPLOYER'S SIGNATURE & DATE |
| |
| 9.0 SPONSOR DETAILS |
| a) SPONSOR'S NIQS MEMBERSHIP NUMBER: | 03929 | | b) SPONSOR'S FULL NAME: | AFE ADEDEJI PETER | | c) SPONSOR'S EMAIL ADDRESS: | AFE.PETER@YAHOO.COM | | d) SPONSOR'S CONTACT ADDRESS: | P.O.BOX 7342 SECRETARIAT IBADAN OYO STATE | | e) SPONSOR'S MEMBERSHIP GRADE: | MEMBER | | f) SPONSOR'S RESGISTRATION DATE:: | 2017-10-12 |
|
| |
| g) I hereby declare that to the best of my knowledge, the particulars given by me and the applicant here are true and correct. |
| |
 SPONSOR'S SIGNATURE & DATE |
| |
| 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.
|
| Applicant's Signature.......................................................................... Date.............................................. |
| |
| 11.0 STATE CHAPTER CHAIRMAN/SECRETARY (COMPULSORY) TO BE COMPLETED MANUALLY |
| CHAPTER: | OYO | | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
|
|
|