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APPLICATION FORM


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 

 

Name of
Examination

Division/Grade
 % of Marks
 

Year of
Passing

Duration of Course

Board/ University

Subject of
Specialisation

1.

2.

3.

4.

5.

 

Experience :

Name of Firm

Post held

Part time/ Contract Basis/ Ad-hoc/ regular/ Temp./pmt.

Total Period (in years)

Years

Months

Nature of Duty

1.

2.

3.

4.

5.

 

Any other relevant  
information :  

 
   

Place :  * 

 

 

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.