PROFILE FORM

Name: ______________________________________________ Age: ______

Address: ____________________________________________ Sex: ______
____________________________________________
Email Address: _______________________________________
Contact Number: ________________ Degree: BS MS PhD
Company/Institution: __________________________________
Employment Status: Permanent Job Order Casual Others:_________
Designation: _______________ Number of years employed: ________
Do you have any experience related to online courses? Yes No
Internet Connectivity Available: Wifi / DSL
Mobile Data (4G/LTE)
Others (Please specify): _____________
Device Available: Cellphone
Laptop / PC
Others (Please specify): ________________
Location of Study: Home
Office / Workplace
Others (Please specify): ________________
Estimated time to study (per week): Less than 3 hours 11-14 hours
3-6 hours More than 15 hours
7-10 hours
What specialization are you planning to pursue?
Artificial Intelligence and Machine Learning Industry 4.0 Technologies
Data Science and Analytics Innovation Management
Value Chain Management Research Management
Technological Entrepreneurship Technology Forecasting
Others (Please specify): ___________________