APPLICATION FORM FOR ELECTION INTO FELLOW MEMBERSHIP GRADE

Please Refer To The Application Guidelines And Ensure That All Parts Of This Form Are Fully Completed In Capital Letters Before Submitting.

  1. Personal details

SURNAME:
OTHER NAMES:: / DATE OF BIRTH:
TITLE(S) (If applicable)
Membership GRADE: / REGISTRATION No: / MEMBERSHIP No:
CORBON REGISTRATION No:
CONTACT DETAILS - TELEPHONE Nos: / EMAIL ADDRESS:
HOME ADDRESS:
OFFICE ADDRESS:
WORKPLACE/COMPANY:
POSITION:
  1. Schools Attended And Qualifications Attained

School / Qualification / Date
  1. Details of Work Experience
  1. POSITIONS HELD

Organization / Positions held / Date
  1. LIST/SCOPE OF BUILDING PRODUCTION PROJECTS YOU HAVE HANDLED EITHER AS A RESIDENT BUILDER, PROJECT MANAGER OR PRIME CONSULTANT

Role Played / Scope of Work / Contract Value / Duration of Contract
  1. Services and Participations in The Activities of the Institute/Profession
  1. NIOB ELECTIVE POSITIONS HELD(National and States)

Position / Date
  1. NIOB COMMITTEE APPOINTMENTS(National And States)

Position / Date
  1. CORBON COMMITTEE APPOINTMENTS

Position / Date
  1. ASSIGNMENTS/REPRESENTATIONS ON BEHALF OF CORBON/NIOB

Assignment / Date
  1. MCPD RECORDS CONFERENCES, TRAININGS,SEMINARS AND WORKSHOPS FOR THE PAST FIVE(5) YEARS

Programme Details / Location / Date
  1. List of Publications to Date

Publication Titles / Book/journal Article/Conference Papers/Workshop Proceedings / Date
  1. State Chapter/Referee Endorsements

REFEREE(1)

I, Bldr.……………………………………………………………………… a financial member of the…………………………………… Chapter, and a FELLOW of the Institute , having read and studied the relevant provisions in the constitution as it relates to transfer into the fellowship grade, do hereby recommend/referee Bldr. …………………………………..……………..for transfer from CORPORATE to the FELLOW grade of the Institute. I do attest to his suitability for the intended position and also confirm that all the information and documents he availed for the purpose are true and correct.

SIGNATURE ……………………………………Membership No …………CORBON License No………..DATE………………..

Email Address……………………………………………………………….. Telephone ……………………………………………………..

REFEREE(2)

I, Bldr. …………………………………………………………………… a financial member of the…………………………………… Chapter, and a FELLOW of the Institute , having read and studied the relevant provisions in the constitution as it relates to transfer into the fellowship grade, do hereby recommend/referee Bldr…………………………………..……………..for transfer from CORPORATE to the FELLOW grade of the Institute. I do attest to his suitability for the intended position and also confirm that all the information and documents he availed for the purpose are true and correct.

SIGNATURE ……………………………………Membership No …………CORBON License No………..DATE………………..

Email Address……………………………………………………………….. Telephone ……………………………………………………..

REFEREE(3)

I, Bldr……………………………………………………………………… a financial member of the…………………………………… Chapter, and a FELLOW of the Institute , having read and studied the relevant provisions in the constitution as it relates to transfer into the fellowship grade, do hereby recommend/referee Bldr …………………………………..………………..for transfer from CORPORATE to the FELLOW grade of the Institute. I do attest to his suitability for the intended position and also confirm that all the information and documents he availed for the purpose are true and correct.

SIGNATURE ……………………………………Membership No …………CORBON License No………..DATE………………..

Email Address……………………………………………………………….. Telephone ……………………………………………………..

MANDATORY STATE CHAPTER RECOMMENDATION

I, Bldr.…………………………………………………………………………………….., Chairman/Secretary…………………………… Chapter, do hereby confirm that the applicant Bldr…………………………………………………………………………………. is an active member of this Chapter. He is also a practicing Builder and domiciled in …………………………………. State.

SIGNATURE ……………………………………Membership No …………CORBON License No………..DATE………………..

Email Address……………………………………………………………….. Telephone ……………………………………………………..

OFFICIAL USE ONLY

TheAdhoc Committee for interview of applicants to the membership grade of FELLOW does confirm that the application has satisfied the following criteria:

  1. Application received within the given deadline? YES/NO
  2. Candidate is financially up to date? YES/NO
  3. All referees are financially up to date? YES/NO
  4. State Chapter Chairman/Secretary financially are up to date YES/NO
  5. Application Recommended by State Chapter YES/NO
  6. Applicant attached all the required documents/reports/certificates YES/ NO
  7. Applicant met the constitutional requirements for age YES/NO
  8. Applicant has been a corporate member for not less than ten(10) years YES/NO
  9. Application validly recommends candidate for interviewYES/NO

Chairman…………………………………………………Signature………………………………………Date…………………

Secretay…………………………………………………..Signature…………………………………………Date…………………

NOTES

For full details on documents which must be submitted with your application, please see The Criteria and Guidance Notes for Fellowship Applicants which should be issued alongside this application form

1. Your CV should include the following

A current CV (no more than 2 sides of A4). This should include the last 10 years of employment (dates, company and job title) but mainly focusing on the last 5 years, giving a more detailed account of your role and responsibilities.

2. Your work-related information

a) The annual turnover, type and range of work of the employing organization. For those in education, give courses offered or serviced by the faculty/department/school in which you are employed:

b) Where relevant, the number and type of employees both directly employed and sub-contracted in the organization for which you are responsible:

3. Expression of your case for Fellowship

Answer only ONE question, either a, b, or c .Please indicate which question either a), b) or c) you are answering and, where possible, answer in bullet point format.

a) What have you done to develop or change an organization or part of it? Why was it done, what was your role and influence, how did you do it and what benefits resulted?

b) What significant contribution have you made to the construction industry or to significant construction projects? What was your role and influence in it, and what were the benefits that resulted?

c) What significant contribution have you made to construction knowledge? What was your role and influence in it and what were the benefits that resulted?

4. Statement relating to Continuing Professional Development

Discuss the benefits, experienced by yourself and your work colleagues, of continuing professional development through a description of your most recent personal development and your future development plan. List your CPD records to sequentially reflect the certificates you submitted.