| 1.0 PERSONAL DETAILS |
| NIQS MEMBERSHIP NUMBER: | P02186A | | SURNAME: | AMINU | | OTHER NAMES: | HASSAN SADIQ | | TITLE/GENDER: | MR./MALE | | DATE OF BIRTH: | 1994-11-21 | | CHAPTER: | KANO | | PHONE NUMBER: | 08167672938, | | EMAIL ADDRESS: | hassanaminu00@gmail.com | | POSTAL ADDRESS: | NO 206 KANKAROFI QUARTERS, KANO | | CURRENT MEMBERSHIP GRADE: | PROBATIONER | | DATE OF REGISTRATION: | 2023-03-24 | | 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 | C5 | | PHYSICS | B3 | | CHEMISTRY | B3 | | AGRIC SICENCE | C4 |
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| 4.0 EDUCATION: |
| SN | UNIVERSITY/INSTITUTION | COUNTRY | DEGREE/DIPLOMA NAME (eg. B.Tech Quantity Surveying) | DATE COMPLETED |
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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) |
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| 7.0 PROFESSIONAL EXPERIENCE: |
| SN | EMPLOYER'S NAME AND ADDRESS | POSITION HELD & DATES | DUTIES |
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| 8.0 EMPLOYER DETAILS |
| a) NAME OF EMPLOYER: | | | b) EMPLOYER'S BUSINESS ADDRESS: | | | c) NATURE OF EMPLOYER'S BUSINESS: | | | d) POSITION OF APPLICANT: | | | e) DATE OF EMPLOYMENT: | |
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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: | P02186A | | b) SPONSOR'S FULL NAME: | AMINU HASSAN SADIQ | | c) SPONSOR'S EMAIL ADDRESS: | HASSANAMINU00@GMAIL.COM | | d) SPONSOR'S CONTACT ADDRESS: | NO 206 KANKAROFI QUARTERS, KANO | | e) SPONSOR'S MEMBERSHIP GRADE: | PROBATIONER | | f) SPONSOR'S RESGISTRATION DATE:: | 2023-03-24 |
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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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