GOVERNMENT OF MAHARASHTRA
ZILHA PARISHAD THANE
RURAL DEVELOPMENT AND WATER CONSERVATION DEPARTMENT
APPLICATION FOR REGISTRATION OF DEGREE/DIPLOMA ENGINEERS AS CONTRACTORS
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1 |
Name of the Applicant And Present Permanent Address |
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2 |
Date of Birth |
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3 |
Place of Birth |
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4 |
Technical Qualification With Year of Passing (Degree/Diploma/Name of Institute/University) |
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5 |
Place of Business |
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6 |
Name of the Banker And Full Address |
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7 |
Class in Which Enrolment is Sought |
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8 |
Weather Enlisted in the Dept Or Any Other Organisation If so State The Category And Enclose Copy Of Certificate |
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I Certified That I have Not Been / Will Not Be Get Registered As Contractor in The Department Under More Than One Name
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