Application Form

Name of
Examination

Division/Grade
% of Marks

Year of
Passing

Duration of Course

Board/ University

Subject of
Specialisation

APPLICATION FORM

THE BRIHAN MUMBAI ELECTRIC SUPPLY & TRANSPORT UNDERTAKING(OF THE BRIHAN MUMBAI MAHANAGARPAKILA)
ELECTRIC SUPPLY BRANCH
ANCILLARY ESTABLISHMENT TRAINING & INDUSTRIAL ENGINEERING DEPARTMENT

Name of
the course :

Full Name of
the Candidate * :

Surname	First Name	Middle Name

Date of Birth :

Gender * :

Marital Status * :

Father's/Husband's
Name* :

Mailing Address :

Pin Code :

Tel. No. :

Mobile * :

Email ID * :

Nationality :

Whether Physical
Handicapped? *

Community : *

All Educational/other professional Qualifications: SSC Onwards

Experience :

	Name of Firm	Post held	Part time/ Contract Basis/ Ad-hoc/ regular/ Temp./pmt.	Total Period (in years)
	Name of Firm	Post held	Part time/ Contract Basis/ Ad-hoc/ regular/ Temp./pmt.	Years	Months	Nature of Duty
1.
2.
3.
4.
5.

Any other relevant
information :

Place : *

Upload your recent passport size photograph :

Upload signature :

Declaration :

I hereby declare that all the statements made by me in the application form and information sheet are true and complete to the best of my knowledge and belief and nothing has been concealed or suppressed. I also understand that in case, any of my statements is found untrue during any stage of course period, I shall be disqualified for the same and I shall be liable for any penal action.