ELECTRICITY DISTRIBUTION DEPARTMENT

License Application Form

Type of Application

New

11Kv Electrical Jointer

Category :

Renew

Replace

LV Electrical Jointer

MV Panel Protection Testing Engineer

Assistant
LV Panel Protection Testing

Linesman

Fitter

MV Panel Protection Testing

License No. (in the case of

Renewal/Lost OR Damaged)

Date of Expiry

1. Company Details:
Name

CR No.

Address

Telephone

P.O. Box:

City

Country

Email ID

Mobile

Qatar

2. Candidate Details:
Name
Sponsor
Name

D.O.B

Qualification

Mobile

Date of
Expiry
Date of
Passport No.
Expiry
Note: All applications must accompany attachments as per the requirements mentioned in EDP1 for the respective trade selected
RP No.

3. Authorized Authority
Name :
Position
:
Signature
:
Company Stamp & Date:

Note:

ED-P1/F8

Incomplete/improper applications will be rejected.

Issue: 0

16-04-2015

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