Queen’s Park Estate Simawa’s Application Form
Questions
marked by * are required.
1. Upload Passport Photo *
2. Title: *

  • Mr.
  • Miss
  • Mrs.
  • Dr.
  • Chief
3. Surname: *
4. Other Names: *
5. Residential Address: *
6. Date of Birth:
7. Nationality: *
8. State of Origin:
9. Telephone: *
10. Occupation:
11. E-mail: *
12. Postal Address:
13. Marketer Name/Phone No:
14. Next of Kin: *
15. Address (Next of Kin): *
16. Tel (Next of Kin): *
17. Payment Terms: *

  • Outright (1.5 million naira)
  •  12 Months (150,000 naira Monthly)
18. Number of Plots: *
19. Plot Options: *

  • Residential
  • Commercial
20. Proposed use of Land: *

  • Bungalow
  • Storey Building
21. Attestation: *

Agree Disagree