TESDA-OP-CO-05-F26

Rev. 00 – 03/01/17

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY

Pangasiwaan sa Edukasyong Teknikal at Pagpapaunlad ng Kasanayan

 APPLICATION FORM
REFERENCE NUMBER :
Qual – YY Region Province Number Series Number Series
alpha
code Assigned to AC
PICTURE
UNIQUE LEARNERS IDENTIFIER (ULI): colored,
- - - -
passport size,
to be filled – out by the Processing Officer

Applicant’s Signature Date of Application

Name of School/Training Center/Company: FOUR J AND E TECHNICAL SCHOOL INC.

Address: SUMILLANO BLDG. MAX SUNIEL ST. CARMEN CAGAYAN DE ORO CITY

Title of Assessment applied for: ELECTRICAL INSTALLATION AND MAINTENANCE NCII
 Full Qualification  COC  Renewal
1. Client Type
 TVET Graduating Student  TVET graduate  Industry worker  K-12  OWF
2. Profile
2.
1.
Name:

 SURNAME
 FIRSTNAM 
E
 MIDDLE  MIDDLE INITIAL
NAME EXTENSION
(e.g. Jr., Sr.)
NAME
2. Mailing
2. Address:
Number, Street Barangay District

City Province Region Zip Code

2.3. Mother’s Name 2.4. Father’s Name
2.5. Sex 2.6. Civil 2.7. Contact Number(s) 2.8. Highest Educational 2.9. Employment Status
Status Attainment
 
 Male  Single Tel: Elementary Graduate Casual
 
 Female  Married Mobile: High School Graduate Job Order
 
 Widow/er E-mail: TVET Graduate Probationary
 
 Separated Fax: College Level Permanent
 
College Graduate Self - Employed
Others:
 
Others: ____________ OFW
2.1 Birth date 2.1 Birth 2.1
M M D D Y Y Age:
0 (mm/dd/yy): 1 place: 2
3. Work Experience (National Qualification-related)
3.1. 3.2. 3.3. 3.4. 3.5. 3.6
Monthly Status of No. of Yrs.
Name of Company Position Inclusive Dates
Salary Appointment Working Exp.
(For more information, please use separate sheet)

4. Other Training/Seminars Attended (National Qualification-related)

4.1. 4.2. 4.3. 4.4 4.5
Title Venue Inclusive Dates No. of Hours Conducted By

(For more information, please use separate sheet)

5. Licensure Examination(s) Passed

5.1. 5.2. 5.3. 5.4. 5.5. 5.6.
Year
Title Taken Examination Venue Rating Remarks Expiry Date

(For more information, please use separate sheet)

6. Competency Assessment(s) Passed

6.1. 6.2. 6.3 6.4. 6.5. 6.6.
Qualificati
Title on Level Industry Sector Certificate Number Date of Issuance Expiration Date

(For more information, , please use separate sheet)


ADMISSION SLIP
REFERENCE NUMBER :

Name of Applicant: Tel. Number: PICTURE

Assessment Applied for: Official Receipt Number:

(Passport
Date Issued:
size)
To be accomplished by the Processing Officer
Name of Assessment Center:

Check submitted requirements: Remarks:

 Bring own Personal Protective Equipment

 Accomplished Self-Assessment
Guide

 Three (3) pieces colored passport size pictures

 Others. Pls. specify

Assessment Date: Assessment Time:

Printed Name & Signature of Processing Officer Printed Name & Signature of Applicant

Date: Date:

Note: Please bring this Admission Slip on your assessment date.

 TESDA-OP-QSO-02-F07
Rev.No.00-03/01/17

Reference No.
to be filled out by the Processing Officer

SELF ASSESSMENT GUIDE

Qualification: ELECTRICAL INSTALLATION AND MAINTENANCE NCII

Performing roughing-in activities, wiring and cabling works

for single-phase distribution, power, lighting and auxiliary
Units of Competency systems Install Electrical Protective devices for distribution,
Covered: power,lighting,auxiliary,lightning protection and grounding
system Install Wiring Devices of Floor and Wall Mounted
Outlet Lighting
Fixture/Switches and Auxiliary Outlets
Instruction:
 Read each of the questions in the left-hand column of the chart.
 Place a check in the appropriate box opposite each question to indicate your
answer.
Can I? YES NO

Communicate and confirm instructions for the preparation of
work activity to ensure clear understanding*
Interpret electrical plan and detailed drawing*
Identify and check to ensure that tools, equipment and
personnel protective equipment needed to electrical system*
Identify and check auxiliary equipment, if it is works correctly
and are safe to use in accordance with established procedures*
Use safety harness or PPE properly*
Bend and install type of conduit and cable tray as per job
requirement.*
Perform correct procedures for installation of electrical auxiliary
system in line with job requirements*
Ensure work is completed in an agreed scheduled time in
accordance with the quality standard.*
Respond to unplanned events or conditions accordingly*
Terminate/Splice conductors/wires in accordance with the
existing electrical standards*
Apply methods and techniques in wiring and cabling installation*
Perform installation qualification (IQ) activities*
Perform operational qualification (OQ) activities*
Install Electrical Protective devices for distribution, power,
lighting, auxiliary,
lightning protection and grounding system
Communicate and confirm instructions for the preparation of
work
activity to ensure clear understanding*
Interpret electrical plans and detailed drawing*
Identify and check to ensure that tools, equipment and PPE
needed to electrical system and by auxiliary equipment works
correctly and are safe to use in accordance with established
procedures*
Follow safety procedures and the use of safety harness*
Perform correct procedures for the installation/mounting
configuration of electrical protective devices and grounding
system*
Respond to unplanned events or conditions accordingly*
Select the types of lighting fixture and auxiliary outlet for the
installation*
Undertake ongoing checks of quality of work in accordance with
instructions and requirements*
Terminate/Splice conductors/wires in accordance with the
existing
electrical standards*
Make final checks to ensure that work conforms to instructions
and
drawing/diagram. *
Perform the installation economically*
Perform commissioning activities*
Install Wiring Devices of Floor and Wall Mounted Outlet Lighting
Fixture/Switches
and Auxiliary Outlets
Read and interpret drawings in accordance with job
requirements*
Set the lay-out and dimension of electrical drawing or wiring
diagram. *
Select and identify correct rating, quantity, sizes and type of
wiring
devices, switches, lighting fixture and convenience outlet*
Identify the specifications of materials, tools and equipment
Fill up properly requisition forms according to list of materials,
tools
and equipment
Follow safety procedures according to enterprise and
government
regulations and select the correct PPE in line with safety
requirements*
Identify defective and/or substandard electrical materials and
report to immediate supervisor*
Lay out, mount and install electrical components, wiring materials
such as conduit and fittings in accordance with standards*
Install wiring protective devices and grounding system properly*
I agree to undertake assessment in the knowledge that information gathered will only
be used for professional development purposes and can only be accessed by
concerned assessment personnel and my manager/supervisor.

___________________________________ Date:
Candidate’s Name & Signature
Evaluated by:
EVELYN A. IÑIGO  Qualified for Assessment
AC Manager
 Not yet Qualified for Assessment
Date: