| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P00299U | | SURNAME: | UKAEGBU | | OTHER NAMES: | CHIBUIKE GOSPEL | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1993-03-18 | | CHAPTER: | LAGOS | | PHONE NUMBER: | 07063157596, | | EMAIL ADDRESS: | chibuikeukaegbu55@gmail.com | | POSTAL ADDRESS: | 2 IJEDA STREET, AGRIC, IKORODU,LAGOS. | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2023-07-05 | | DIET: | MARCH, 2026 | | DISABILITY: | NO |
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| 2.0 PREFERRED INTERVIEW CENTRE: |
| LAGOS |
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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 | C4 | | AGRIC SICENCE | C6 |
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| 4.0 EDUCATION: |
| SN | UNIVERSITY/INSTITUTION | COUNTRY | DEGREE/DIPLOMA NAME
(eg. B.Tech Quantity Surveying) | DATE COMPLETED | | 1 | ENUGU STATE UNIVERSITY OF SCIENCE AND TECHNOLOGY, ENUGU | NIGERIA | BSC IN QUANTITY SURVEYING | 2020-09-03 |
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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/2025/07/174 | 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 | PORT AGO CONSTRUCTION LIMITED | QUANTITY SURVEYOR (2025-10-20 - Date) | PROJECT MANAGEMENT, PREPARATION OF BILL OF QUANTITIES, SITE CORDINATION AND VISITATION, VALUATION, FINAL ACCOUNT, ETC |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | PORT AGO CONSTRUCTION LIMITED | | b) EMPLOYER'S BUSINESS ADDRESS: | 12C MOLADE OKOYA, MERIT RESIDENCES, ADENIYI JONES, IKEJA, LAGOS | | c) NATURE OF EMPLOYER'S BUSINESS: | REAL ESTATE | | d) POSITION OF APPLICANT: | EXECUTIVE FACILITATOR | | e) DATE OF EMPLOYMENT: | 2025-10-20 |
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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: | 02694 | | b) SPONSOR'S FULL NAME: | OLOGUNDUDU BAMIDELE ODUNAYO | | c) SPONSOR'S EMAIL ADDRESS: | OLOGUNDEL@YAHOO.COM | | d) SPONSOR'S CONTACT ADDRESS: | ARABELLA LANDSCAPE LTD, P O BOX 171 FESTAC TOWN, 22 RD F CLOSE BLOCK 1, FLAT 3, FESTAC, LAGOS | | e) SPONSOR'S MEMBERSHIP GRADE: | FELLOW | | f) SPONSOR'S RESGISTRATION DATE:: | 2023-11-14 |
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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: | LAGOS
| | NAME: |
| | NIQS MEMBERSHIP NUMBER: |
| | DESIGNATION: |
| | PHONE NUMBER: |
| | DATE: |
| | EMAIL: |
| | SIGNATURE: |
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PC89