Certificate in Food & Beverages Operations Online Form

Select Your Course Name*

Personal Particulars (in Block Lettes)

Surname/Family Name (as per NRIC/FIN/Passport)*

Family Name (as per NRIC/FIN/Passport)*

Email ID*

Mobile NUmber*

NRIC/FIN/Passport Number (International Applicant)*

Upload NRIC/FIN/Passport

Nationality

Gender

Race

Marital Status

Residential Address (in Singapore)

Overseas Address (For International Applicant Only)

Family Particulars

Family Contact Person Name

Family Contact Person Relationship

Family Contact Person Mobile

Family Contact Person Email

Emergency Contact

Emergency Contact Person Name

Emergency Contact Person Relationship

Emergency Contact Person Number (Home)

Emergency Contact Person Mobile

Emergency Contact Person Email

Qualification

Highest Qualification

Upload Highest Qualification Document

Have you enrolled for any WSQ course(s) or module(s) with IIHM and / or other training provider previously?

Yes

Please provide details on course/module tide(s) and qualifiction attained if you have replied 'Yes' to the above and submit copies of certificate.

Employment History

Company1 Name

Company1 From (Month/Year)

Company1 To (Month/Year)

Company1 Country

Company1 Position

Company2 Name

Company2 From (Month/Year)

Company2 To (Month/Year)

Company2 Country

Company2 Position

Other Information

Have you been arrested by the police or convicted of criminal offence?

Yes

Do you have any existing criminal record(s) in Singapore or overseas?

Yes

have you suffered or are suffering from any medical condition, physical impairment and psychological related illness.

Yes

(Please provide supporting medical documents)

Have you been diagnosted with, or experienced learning disabilities/special learning needs in previous ecucation?

Yes

(Please provide supporting medical documents)

Have you been granted or leave applied for access arraignments is in previous examinations/assessments?

Yes

Please provide details if you have answered "Yes" for any of the above question.

Company Sponsorship

This is to certify that the appicant (name as per NRIC)

will be fully sponsored by (Company Name and UEN as per ACRA

The Sponsoring Company is a Small and Medium Enterprise(SME)

Name of Contact Person

Date

Billing Company

Billing Address

Contact Number(Office)

Fax

Payment

All fees are payable to IIHM Education PTE Ltd by PayNow/bank transfer, details as follows:

PayNow : UEN:202134816G
Bank Name : DBS Bank Ltd.
Bank account no : 0725154944

For international transfer :
BDS SWIFT code : DBSSSGSG
Address : 12 marina Boulevard, DBS Asia Central, Marina Bay Financial Centre Tower 3, Singapore 018962

Please mention Name and Student ID no in the reference/description field

Personal Data Protection and Privacy Policy

I understand and acknowledge that

IIHM is committed to maintain the confidentiality of my personal information and will undertake not to divulge any of my personal information to any third party without my prior written consent, subject to the obligation of IIHM to disclose to any Singapore government authority, statutory boards, agencies and/or to the organisation confessing/ awarding the qualification, any information relating to me in compliance with the law and/or fulfilment of obligatory requirements associated with my enrolment to IIHM.
IIHM is authorized to contact, correspond and send information for school related purposes to me through any of the contact modes as provided within this application.

Personal Data Protection and Privacy Policy

I hereby declare that all information provided by me in connection with this application is true, accurate and complete. I understand that any inaccurate, incomplete or false information given or any omission of information required shall render this application invalid and IIHM may at its disection withdraw any offer of acceptance made ot me on the basis of sich information or if already admitted, I may be liable to disciplinary action which may result in my expulsion from IIHM. I hereby authorize IIHM to obtain and verify any part of the information gven by me from or with any source, as it deems appropriate.

Upload Signature/Name

Name/Surname

Date