REGISTRATION FORM FOR CLASS A ELECTRICAL CONTRACTOR
* mark fields are mandatory
Details of Registration Form
Please Select Region Type : * Indore RegionUjjain Region
Name of Firm / Company / Contractor : *
Postal Address of Firm :*
Address of Firm :*
State :*  Division :* 
District :* Tehsil :*  
Pin Code :*
Communication Reference of the Company/Firm
Phone No. [Office] with STD Code : Fax No. [Office] with STD Code :
Mobile No : * E-Mail ID [Firm] :*
Essential Pre Qualification Requirement

"A" Class Electrical Contractor Licence issued by the Electrical Safety Department,Govt. of MP.

"A" Class Licence Number :* Issue Date (dd/MM/yyyy) :*
Valid up to date (dd/MM/yyyy) :* Issuing Authority :*
Issued on the name of : * 'A' Class Licence Certificate :
(In .Jpg/.Jpeg/.Pdf Format and 10KB-100KB) *
Note : Self attested Copy of Licence essentially be submitted, failing which the case for registration shall not considered.

P.W.D. Registration

Registration Number:* Issue Date (dd/MM/yyyy) :*
Branch of Registration :* Class of Registration :*
Valid up to date (dd/MM/yyyy) :* Issuing Authority : *
Issued on the name of : * P.W.D. Registration Certificate :
(In .Jpg/.Jpeg/.Pdf Format and 10KB-100KB) *
Note : Self attested Copy of Registration essentially be submitted, failing which the case for registration shall not considered.