COUNCIL FOR THE REGULATION OF ENGINEERING IN NIGERIA
22 Addis Ababa Crescent Wuse Zone 4
P.O.Box 8461, Wuse, Abuja.
PROPOSERS' CONFIRMATION FORM
*TWO PROPOSERS (Must be on COREN register and up-to-date in the payment
of their dues to COREN). We hereby certify to the best of our knowledge that:
Mr/Mrs/Miss is
of good character and is fit and proper to be placed on the register of Council for
the Regulation of Engineering in Nigeria and therefore propose him/her to the
Council.
(i) Name: _
Address
COREN Reg. No
Academic/Professional/Qualification Status _
Position
Append your Security Seal here and sign.
**See Sample Below**
(ii) Name:
Address
COREN Reg. No
Academic/Professional/Qualification Status _
Position
Append your Security Seal here and sign.
**See Sample Below**
**Please fill this form and scan back on the space provided on the portal.
CERTIFICATION BY APPLICANT
I _________________________________________________________________________________________
hereby declare that the information contained in my application is correct and I fully understand the
conditions as stipulated in Decree 55/70 as amended by Decree 27/92 now Act CAP E11/2004 under which
consideration is being given to my application for registration.
Date____________________________ Signature of candidate______________________________________
SAMPLE SECURITY SEAL