Application form for Examination of Chartered Electrical Safety Engineer


Personal Details
Applicant Full Name: *
Father Name: *
DOB:(DD/MM/YYYY) *
Email id: *
Gender: *
Online Exam Center:*
Current Address: *
State * District:*
Pincode: * Voter id/ Driving License / passport Number: *
Mobile Number: *
Education Qualification Details: *Note: The Candidate can opt Bachelor's degree in Electrical Engineering OR Diploma in Electrical Engineering
ExamSubjectYear of Passing(YYYY)Education QualificationName of the Board/ University




























Department fees payment information:
Challan No * CRN No * Date of Payment *(DD/MM/YYYY) Amount *




Experience details: Note:Experience count till date(01/04/2024)
Name of the OrganizationEmail IdPhone Number. Ex-(09999555555)Post heldFrom date (DD/MM/YYYY)To date (DD/MM/YYYY)Place of postingDescription of nature of work indicating voltage CategoryCategory (HV/EHV) Industrial/Non- Industrial/Other  
* * * * * * * * *
Photo & Signature (.jpg फाइल)(150KB) *