HMI Institute

Salutation * :

Trainee Name (as in NRIC / Passport) * :

ID Type * :

ID Number * : Please add correct ID Number.

Date of Birth * :

Age* :

Mobile Number * :

Email * :

Course Preview Session* :

By registering for this course, I accept Terms and Conditions

Verification Code * :

How did you come to know about HMI Institute? * :

Name of HR Director/Mgr :

Office DID :

Mobile Number :

Email :

Company Address :

Postal Code :

UEN* :

Does your company have at least 30% local shareholding?

Does your company have more than S$100 million annual sales turnover?

Company Address * :

Postal Code* :

Click if same as Company Address

Billing Address * :

Billing Postal Code* :

Contact Person Email* :

Contact Person Name * :

Contact Person Contact Number* :

Ext. :

Photo :

Note :File must be JPG, GIF ,PNG or BMP And Max Size 1 MB.

Salutation * :

Trainee Name* :

Pass Type * :

ID Number * : Please add correct ID Number.

Card Type * :

Date of Birth * :

Age* :

Contact Number * :

Home Tel Number :

Email * :

Nationality * :

Race* : Please select an item in this field list.

Marital Status * :
Single Married Divorced Widowed

Address * :

Postal Code * :

Gender * :
Male Female

If billing address same as residential address

Billing Address * :

Billing Postal Code * :

Weight (kg) * :

Height (m) * :

I have Community Health Assist Scheme (Chas) Blue Card* :
Yes
No

Chas Card Valid From [eg.DD/MM/YYYY] * :

Chas Card Expiry Date [eg.DD/MM/YYYY] * :

Age :

Relationship :

Occupation :

Identity No.

Relationship * :

Home Tel. No. :

Mobile Phone No. * :

Name of School/College/Institution * :

Qualification Attained * :

Period of Study (From)* :

Period of Study (To) (blank for still ongoing) :

Highest Educational Document * :

List Subject(s) Passed (C6 and above) if the highest qualification is GCE ‘N’/’O’ Level * :

Listen :

Read :

Speak :

Write :

Numeracy :

IT Skills: (e.g. MS Office, etc.) * :

Name of Employer * :

Period of Working (From)* :

Period of Working (To) (blank for still ongoing) :

Job Designation * :

Last Salary (S$) :

Reason for Leaving :

Please indicate here the INDUSTRY of your most recent employment * (Example: Healthcare / Community Care / Food & Beverages / Retail / Logistics / Security / etc.) :

Have you completed National Service? * :
Yes No Not Liable

NS Unit * :

Rank * :

Vocation * :

NS Ord Date * :

Have you been diagnosed with any medical / health problem? * :
Yes No

If Yes, please specify:* :

Are you undergoing any psychiatric treatment currently or previously? * :
Yes No

If Yes, please specify:* :

Are you suffering from any physical disability and/or problem with hearing / vision? * :
Yes No

If Yes, please specify:* :

Have you ever been convicted of any criminal offence? * :
Yes No

If Yes, please specify:* :

Are you currently placed on probation order by the local court? * :
Yes No