New Members
SURVEYORS COUNCIL OF NIGERIA (SURCON)
APPLICATION FOR REGISTRATION
SURVEYORS' COUNCIL OF NIGERIA (SURCON)
PERSONAL DATA
Surname:
Maiden Name (F):
Other Names (S):
Birth Place
Birth Date
Marital Status:
State of Origin:
Nationality
Personal Contact Info:
Office:
Residence:
GSM:
Fax:
E-mail:
Login for Surcon site will use your email, and the password you enter:
Password:
Office Address:
Postal Address:
Residential Address:
Date:
EDUCATIONAL QUALIFICATION
College or secondary education:
Name of school & address
Years of study ( from - to)
Certificates or diplomas obtained
Year of Award
Tertiary or Higher Institution:
Name of school & address
Years of study ( from - to)
Certificates or diplomas obtained
Year of Award
Academic Distinction (if any)
Undergraduate field of study:
Major:
Minor:
Postgraduate field of study:
PROFESSIONAL QUALIFICATIONS (including Membership of Professional Organisations)
Date of Award
Awarding Institution
Qualifications
Licence No. and year of issue (if any):
Professional Distinction (If any):
PROFESSIONAL EXPERIENCE
(State position held, with dates, organizations/firms and duties Performed in chronological order, starting with present position)
PUBLICATIONS/PAPERS (with dates)
ADDITIONAL INFORMATION IF ANY(other courses, workshop etc)
AREA(S) OF PROFESSIONAL SPECIALISATION (Tick as Appropriate)
Land Surveying/General Practice
Photogrammetry/Remote Sensing
Hydrographic Surveying
TYPE OF REGISTRATION REQUIRED (Tick as Appropriate)
Surveyor
Pupil Surveyor
Technologist
Technician
HAVE YOU BEEN CONVICTED OF A CRIMIMAL OFFENCE
Yes
No
If yes, please give details
ATTACHMENTS
Please attach the following:
Evidence of age
Evidence of academic qualification
Evidence of professional qualification
Passport photograph
signature of self and employer
