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Assistant Engineer (D) (On Regular Basis)
Field's marked with* are mandatory
Type of candidate*
Personal Details
Candidate's First Name * Candidate's Last Name*
Father's First Name* Father's Last Name*
Mother's First Name* Mother's Last Name*
Gender* Religion*
Date of Birth(dd/mm/yyyy)* Age as on 01/01/2018
Country of Birth*
State of Birth*
Town of birth*
Domicile of MP:*
Category:*
Marital Status:* Spouse Name *
Date Of Marriage* No. of Children*
Last child birth date isTwins ?
Are You Physically Handicapped ?*
Type Of Physically Handicapped* If handicapped then percentage of disablement*
Are You an Ex Serviceman ?* Aadhaar Card Number *
Communication Address
Line 1*
Line 2*
State* District*
City / Town* Pincode*
Phone No. Mobile No.*
E-mail ID*
Tick here if Permanent Address is same as Communication Address
Line 1*
Line 2*
State* District*
City / Town* Pincode*
Phone No. Mobile No. *
Bank Details
Account Number * Bank Name *
Account Holder Name * IFSC Code *
Educational Qualification(Full Time Course)*
(Is your Qualifying Exam Final Year Result Awaited?) *
S.No Qualification Name of the Degree  Passing Year University/Board   Institute/College Name Total Marks Obtained Marks (% of Marks) 00.00 Division
1 10th HSC
2 12th/Diploma HSSC/Diploma
3 BE/B.TECH/AMIE
*In case your University/Institute does not award marks, please convert grades(CGPA) to Percentage marks and fill.
*Write % of marks with two digits after the decimal. The second digit after the decimal should be rounded off. e.g., if Marks is 60%, then write 60.00%. If marks are 68.938% then write 68.94%.
Gate Qualification Detail*
S.No  GATE Year Registration Number TOTAL MARKS GATE SCORE (% of MARKS OUT OF 100) 00.00 GATE RANK
1 GATE SCORE
 * If case your University/Institute does not award marks, please convert grades(CGPA) to Percentage marks and fill.
Work Experience
Do you have work experience as a departmental candidates of MPSEB and its successor companies ?*
Whether Applicant presently in Government/Corporation/Board/Autonomous Institute and Home Guards
* If yes, NOC from the organization will need to be produced at the time of Joining.
City preferences for Qualifying Examination Center
Preference Details
Sno.Preference Order(ex. 1,2,3)Preference Name
1
City Circle Bhopal
2
O & M Circle Gwalior
3
O &M Circle Bhind
4
O & M Circle Morena
5
O & M Circle Guna
6
O & M Circle Shivpuri
7
O & M Circle Sheopur
8
O & M Circle Bhopal
9
O & M Circle Sehore
10
O & M Circle Vidisha
11
O & M Circle Raisen
12
O & M Circle Hoshangabad
13
O & M Circle Rajgarh
14
O & M Circle Betul
15
City Circle Gwalior
Following Original documents will be produced at the time of Joining
1.Higher Secondary or High School Examination certificate in support of date of birth.
2.Certificate of relevant Diploma/degree with each semester’s mark sheet, from a recognized university.
3.Caste certificate, (in case of reserved category candidates) issued by Sub Divisional Officer (SDO) of MP in prescribed format.
4.MP Domicile certificate in case of candidates appearing for reserved posts.
5.Candidates serving in government / semi government / public sector should submit N.O.C. from the employer.
6.Photo identity card (Passport / Driving license / Voter ID / Bank pass book/ Aadhaar card issued by Unique Identification Authority of India).
7.Proof of permanent address.
8.Widow / Divorcee lady should submit an affidavit / a certificate from court or as applicable as per law.
9.Experience certificate.Only for those who have work experience as departmental candidate of MPSEB and its successor Companies.
10 Certificate only for those who have Experience in Govt./Corporation/Board/Autonomous Institute employees and Home Guards.
Attachments*
Upload Aadhaar Card (Only .jpg document Allowed(max Allowed size is 200kb))*
Upload High School Certificate (Only .jpg document Allowed(max Allowed size is 200kb))*
Upload Higher Secondary School/Diploma Certificate (Only .jpg document Allowed(max Allowed size is 200kb))*
Upload Certificate of BE/B.Tech/AMIE Marksheet of Final Semester(Only .jpg document Allowed(max Allowed size is 200kb))*
Upload Handicap Certificate (Only .jpg document Allowed(max Allowed size is 200kb))*
Upload Gate Certificate (Only .jpg document Allowed(max Allowed size is 200kb))*
Browse Photograph with Signature *

(Click here for Photo & Signature Template)
DECLARATION Read form carefully before submission.
I hereby declare that all the information given in the aforementioned application format is true to the best of my knowledge. I under take and accept that if any of the information given by me is found to be incorrect, then my application will be rejected and if appointed, then my appointment will be terminated & action may be taken accordingly.*