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4TH Revised Application Form For Contractors Consultants Acc Exam PDF
4TH Revised Application Form For Contractors Consultants Acc Exam PDF
18
4th Revision
Department of Public Works and Highways
ACCREDITATION OF CONTRACTORS’/CONSULTANTS’
MATERIALS ENGINEERS
APPLICATION FORM FOR WRITTEN EXAMINATION
_____________________
Date of Examination
APPLICATION NUMBER -
Name :
(Last) (First) (Middle)
Office Address :
Position : Home Tel. No.
Office Tel. No. : Mobile No. TIN
Nationality : Sex Civil Status Birthday
Checked by:
__________________
Position Signature (Sign inside the box)
(DPWH QAHD Personnel)
______________________________________
Date
*The BRS shall invalidate any examination results of examinees eventually found as
Government, GOCC and Job Order engineers.
INSTRUCTIONS
1. Fill-out (type or print) all the applicable spaces of the Application Form
legibly
The Chief
Quality Assurance and Hydrology Division
Any Regional Office of the Department of Public Works and Highways
5. Applicants shall obtain the Notice of Examination Schedule from the DPWH
Office where the application was filed within, one (1) week before the
scheduled examination. The notice shall confirm the date, time and place of
examination. This notice must be presented to the DPWH examination
proctor during the examination.
EXAMINATION COVERAGE