ATTENTION ALL HOMEMAKERS AND HOUSEWIVES


We would like to invite you to participate in our survey which would allow you to be potential trainees in the HEARTS programme.

 
1.
Full Name *:
2.
I/C No*:
(New IC No., input without "-", eg: 681212135664)
3. Age*:
4. Address*:
5. Contact No(H)*: (H/P)*: E-mail*:
6. Educational Qualification*:
Highest Academic Level
(Diploma / Degree / Master / PhD)
Field of Study
Name of Institution  
7. Marital Status*:

Single Married Divorced Widow

8. If Married, Divorced or Widow, how many children do you have?
(If Single, please proceed to Question 9)
9. Working Experience
Year Of Services
Company
Job Title
Main Responsibility
10. What do you want to specialise in?

(1)Pre-contract Examination (For Insurance Agents)
(2)Takaful Examination (For Takaful Agents)
(3)Translation
(4) Script/Creative Writing
(5)Website Development
(6)Application Systems Development
(7)Social Media Management
(8)Research
(9)Certified Project Management
(10)Consultancy Train-the_Trainer
(11)Business Process Contact Centre
(12)Software Tester
(13)Graphic Designer

11. Preferred Training Hours Full-Time(9am-5pm)
12. Preferred Training Duration (1)1 to 3 days only
(2)1 to 5 days only
(3)1 to 10 days only
(4)Duration is not a concern to me as long as I can be trained on specific training programme
13. Are you interested for a guaranteed employement upon the completion of the training programme? Yes
No
14. Preferred Choice of Employment (1)Full Time (8 hours)
(2)Flexi Hour Full Time (8 hours but certain hours can work from home)
(3)Part Time (4 hours)
(4)Flexi Hours Part Time (4 hours but certain hours can work from home)
(5)Project Basis (needs basis)
15. What is your expected range of Salary (1)RM 900 – RM 1,999 per month
(2)RM 2,000 – RM 2,500 per month
(3)RM 2,501 – RM 2,999 per month
(4)RM 3,000 – RM 3,500 per month
(5)RM 3,501 – RM 3,999 per month
(6)More than RM 4,000 per month
(7)I don’t have any expected salary as long as I can secure a job for my family
16. Office Automation
 
Beginner Level
Intermediate Level
Advanced Level
Mastery Level
None
a)Word
b)Excel
c) Power Point
17. Programming
 
Beginner Level
Intermediate Level
Advanced Level
Mastery Level
None
a)Java
b)PHP
c) Oracle
d)SAP

e)Others:

18. Language
 
Beginner Level
Intermediate Level
Advanced Level
Mastery Level
None
a)English
b)Tamil
c)Mandarin
d)Bahasa Melayu

e)Others:

19. Others (Please list down other specialised skills or professional skills that you have been certified or
awarded)
Specialised / Professional Skills
Awarded by
(Name of Institution)
Year Awarded