CONFIDENTIAL

Cinta Abadi Marriage of A Lifetime

MARRIAGE PREPARATION COURSE (MPC) APPLICATION FORM FOR OPERATORS 2013

Administered by:

Supported by:

NOTE TO APPLICANT: 1. Write clearly. 2. Fill up the form with required information. Enter the word NIL or NA where applicable. If space is insufficient, you can use additional papers and attach to the form. 3. Please submit the completed forms via email at: ismailfarhan@mendaki.org.sg. or mail it to: Mr Ismail Farhan Bin Anuar Executive Officer Mendaki SENSE 1 Lorong 6 Toa Payoh, Singapore 319376

SECTION A

ORGANISATION & LIAISON OFFICER(S) PARTICULARS ORGANISATION

Name of Organisation Name of Officer & Designation Mosque / Malay Muslim Organisation / Type of Organisation Community Clubs/ Business Entity*

Address of Organisation

Main Line

Fax

Email
*Please delete accordingly. For business entity outfit, please provide supporting document(s) with the company registration details.

Cinta Abadi MPC OPERATORS APPLICATION FORM

Page 1

CONFIDENTIAL

Cinta Abadi Marriage of A Lifetime

MARRIAGE PREPARATION COURSE (MPC) APPLICATION FORM FOR OPERATORS 2013

Administered by:

Supported by:

LIAISON OFFICERS Name of Liaison Officer 1

Designation

Tel

Fax

Email

Name of Liaison Officer 2

Designation

Tel

Fax

Email

Cinta Abadi MPC OPERATORS APPLICATION FORM

Page 2

CONFIDENTIAL

Cinta Abadi Marriage of A Lifetime

MARRIAGE PREPARATION COURSE (MPC) APPLICATION FORM FOR OPERATORS 2013

Administered by:

Supported by:

SECTION B

DETAILS ON PROPOSED VENUE & LOGISTIC CHECKLIST1

DETAILS ON THE PROPOSED VENUE Name and Address of Venue Reason for the choice of Venue

LOGISTIC CHECKLIST VENUE Yes Training room can accommodate at least 40 participants? Equipment Available for Use During Courses 1. Projectors 2. Screens 3. Computer/ Laptop & speakers 4. Flipcharts 5. Whiteboard 6. Microphones (minimum 2 & cordless recommended) 7. Tables and chairs (cluster seating arrangement) No Comments

One form per venue. For application with more than 1 venue, operators should submit the form for Section B according to the number of venue.

Cinta Abadi MPC OPERATORS APPLICATION FORM

Page 3

CONFIDENTIAL

Cinta Abadi Marriage of A Lifetime

MARRIAGE PREPARATION COURSE (MPC) APPLICATION FORM FOR OPERATORS 2013

Administered by:

Supported by:

SECTION C S/N Month Preferred Date

MPC PROPOSED SCHEDULE FOR YEAR 2014 Venue Capacity (Max 40 Pax) Fees2 Medium3

Note: Confirmed schedule should be submitted by end Nov 2013. SECTION D S/N Name MPC PROPOSED EDUCATORS FOR YEAR 2014 Designation Organisation Contact No Email Teaching Module / Medium4

Note: Confirmed list of trained educators should be submitted by end Nov 2013.
2 3

Recommended fees at $130. Medium: Please indicate (E) for English and (M) for Malay 4 Medium: Please indicate (E) for English and (M) for Malay

Cinta Abadi MPC OPERATORS APPLICATION FORM

Page 4

CONFIDENTIAL

Cinta Abadi Marriage of A Lifetime

MARRIAGE PREPARATION COURSE (MPC) APPLICATION FORM FOR OPERATORS 2013

Administered by:

Supported by:

SECTION E: DECLARATION

I, ________________________________________________, _______________________,
(Name) (IC No)

representing ____________________________________________________________, hereby,

(Name of Organisation)

declare that the information given by me in this Application Form is correct and true to the best of my knowledge and that I have not wilfully suppressed any material fact. give my consent for Mendaki SENSE Pte Ltd being appointed agency of Ministry of Social and Family Development (MSF) to obtain and verify information from or with any source, as you deem appropriate for the assessment of my application to be Cinta Abadi MPC Operators. fully understand and accept that if at any time after engagement, it is found that a false declaration has been made in this form, MSF has the absolute right to terminate my contract forthwith without notice and without assigning any reason.

Signature and Date

Organisation Stamp

IMPORTANT All application form and supporting materials must reach us by 2 September 2013 at 12.00 noon. Late and incomplete applications will not be accepted. Only shortlisted candidates will be notified.

Cinta Abadi MPC OPERATORS APPLICATION FORM

Page 5

CONFIDENTIAL

Cinta Abadi Marriage of A Lifetime

MARRIAGE PREPARATION COURSE (MPC) APPLICATION FORM FOR OPERATORS 2013

Administered by:

Supported by:

FOR OFFICIAL USE A) Please tick where appropriate: 1) Applicant form is completed. 2) Applicant provided copies of supporting document. B) On-Site Assessment Date/ Time: Comments:

Name/ Designation

Signature/ Date

Cinta Abadi MPC OPERATORS APPLICATION FORM

Page 6