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Organised By [Program Anjuran]:

Initiatives under the Micro Connector Program [Inisiatif di bawah program Micro Connector]:

Perakuan Penerimaan Pakej Program Latihan Women Netpreneur 2021 di bawah Program Micro Connector oleh SME Corp. Malaysia.

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Corporate

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SECTION A: PARTICIPANT'S PROFILE [BAHAGIAN A: PROFIL PESERTA]

Please key-in big capital letter on each first word [Sila masukkan huruf besar pada setiap perkataan pertama]

Participant's Name [Nama Peserta](Required)

Name as per NRIC [Nama seperti dalam NRIC]

Participant’s MyKad No. [No. Kad Pengenalan Peserta](Required)

Nationality [Kewarganegaraan](Required)

Address [Alamat](Required)

Street Address [Alamat Jalan] Address Line 2 [Talian Alamat 2] City [Bandar] State [Negeri] Postal Code [Poskod] (5 digits)

Phone No. [No. Telefon](Required)

Email [Emel](Required)

Race [Bangsa](Required)

Malay [Melayu]

Chinese [Cina]

Indian [Orang India]

Other

Native [Bumiputera](Required)

Yes [Ya]

No [Tidak]

If yes, please specify (Eg: Iban, Kadazan etc.) [Jika ya, sila nyatakan: (Cth: Iban, Kadazan etc.)](Required)

Native People [Orang Asli](Required)

Yes [Ya]

No [Tidak]

Person with Disabilities/Disabled People [Orang Kelainan Upaya](Required)

Yes [Ya]

No [Tidak]

Age [Umur](Required)

Youth [Belia] (Age [Umur]: 15 – 30 years old [tahun])(Required)

Yes [Ya]

No [Tidak]

Gender [Jantina](Required)

Male [Lelaki]

Female [Perempuan]

Monthly Salary [Pendapatan Sebulan] (RM)(Required)

Education Level [Tahap Pendidikan](Required)

SPM/Certificates [SPM/Sijil Kemahiran]

Diploma

Degree [Ijazah Sarjana Muda]

Other

Working Experiences [Bidang Pengalaman Bekerja](Required)

Manufacturing Sector [Sektor Pembuatan]

Service Sector [Sektor Perkhidmatan]

Others [Lain-lain]

Specify Industry(Required)

Physical or chemical transformation of materials or components into new products.
[Transformasi bahan-bahan atau komponen-komponen secara fizikal atau kimia menjadi produk baharu.]

Specify Industry(Required)

Example: - Distribution businesses; hotels and restaurants [Perniagaan agihan; hotel dan restoran]
- Service Businesses [Perkhidmatan berkaitan perniagaan]
- Professional and ICT [Profesional dan ICT]
- Private education and health care; entertainment [Pendidikan dan penjagaan kesihatan swasta;]
- Entertaiment [Hiburan]
- Financial intermediation [Perantaraan kewangan]
- Manufacturing -related services such as research and development (R&D), logistics, warehousing and engineering [Perkhidmatan berkaitan pembuatan seperti penyelidikan dan pembangunan (R&D), logistik, gudang penyimpanan dan kejuruteraan]
- Other Service Sector, please specify [Sektor Perkhidmatan yang lain, sila nyatakan]

Specify Industry(Required)

- Unemployed [Tidak Bekerja]
- Retired [Bersara]
- Agriculture [Pertanian Asas]
- Construction [Pembinaan]
- Mining & Quarrying [Perlombongan & Pengkuarian]
- Other Industry, please specify [Industri yang lain, sila nyatakan]

Business Products [Produk Perniagaan](Required)

Types of products and services

Website [Laman Sesawang]

Have you started selling in Shopee? [Adakah anda mula menjual di Shopee?](Required)

Yes [Ya]

No [Tidak]

If yes, please state your Shopee Username : [Jika ya, sila nyatakan Shopee Username anda](Required)

Are you a Lazada seller? [Adakah anda penjual Lazada?](Required)

Yes [Ya]

No [Tidak]

If yes, please state your Lazada Seller ID [Jika ya, sila nyatakan Lazada ID anda](Required)

Example: MY(5-8digit/letter)

Do you have Google My Business Account? [Adakah anda mempunyai Akaun Google My Business?](Required)

Yes [Ya]

No [Tidak]

SECTION B: COMPANY'S PROFILE [BAHAGIAN B: PROFIL SYARIKAT]

(Nota : Sila isi maklumat berkenaan sekiranya telah mendaftar perniagaan dengan Suruhanjaya Syarikat Malaysia)

Company's Name [Nama Syarikat](Required)

Company Registration Number [No. Pendaftaran Perniagaan/Syarikat](Required)

Date of Incorporation [Tarikh Penubuhan Syarikat](Required)

Date of Operation [Tarikh Mula Beroperasi Syarikat](Required)

Company's Address [Alamat Syarikat](Required)

Street Address Address Line 2 City State Postal Code

Phone No. [No. Telefon](Required)

Company's Email [Emel Syarikat](Required)

Company's Website [Laman Sesawang Syarikat](Required)

Sector [Sektor](Required)

Manufacturing [Pembuatan]

Service [Perkhidmatan]

Others [Lain-lain]

Specify Industry(Required)

Physical or chemical transformation of materials or components into new products.
[Transformasi bahan-bahan atau komponen-komponen secara fizikal atau kimia menjadi produk baharu.]

Specify Industry(Required)

Example: - Distribution businesses; hotels and restaurants [Perniagaan agihan; hotel dan restoran;]
- Service Businesses [Perkhidmatan berkaitan perniagaan]
- Professional and ICT [Profesional dan ICT]
- Private education and health care; entertainment [Pendidikan dan penjagaan kesihatan swasta;]
- Entertaiment [Hiburan]
- Financial intermediation [Perantaraan kewangan]
- Manufacturing -related services such as research and development (R&D), logistics, warehousing and engineering | Perkhidmatan berkaitan pembuatan seperti penyelidikan dan pembangunan (R&D), logistik, gudang penyimpanan dan kejuruteraan
- Other Service Sector, please specify [Sektor Perkhidmatan yang lain, sila nyatakan]

Select One or Fill Up Your Industry Below [Pilih Satu Atau Isikan Industri Anda di Bawah]

Unemployeed [Tidak Bekerja]

Retired [Bersara]

Specify Industry(Required)

- Agriculture [Pertanian Asas]
- Construction [Pembinaan]
- Mining & Quarrying [Perlombongan & Pengkuarian]
- Other Industry, please specify [Industri yang lain, sila nyatakan]

Company’s Products/Services [Produk/Perkhidmatan Syarikat](Required)

Latest Annual Sales Revenue [Nilai Jualan Tahunan Terkini] (RM)(Required)

Number of Full Time Employees [Jumlah Pekerja Sepenuh Masa](Required)

Micro Size Businesses [Perakuan Perniagaan Bersaiz Mikro](Required)

Micro Enterprise Definition: Annual Sales < RM300,000 OR Employees < 5 people
[Definasi Perusahaan Mikro: Jualan tahunan < RM300,000 ATAU Pekerja < 5 orang]

Yes [Ya]

No [Tidak]

Bumiputera Owned Companies [Syarikat Milikan Bumiputera](Required)

> 60% equity owned by Bumiputera [> 60% ekuiti dimiliki oleh Bumiputera]

Yes [Ya]

No [Tidak]

Women Owned Companies [Syarikat Milikan Wanita](Required)

> 51 % equity is owned by a woman / a woman CEO and owns at least 10% equity of the company.
[> 51% ekuiti dimiliki oleh wanita / Ketua Eksekutif seorang wanita dan memiliki sekurang-kurangnya 10% ekuiti syarikat.]

Yes [Ya]

No [Tidak]

Upload Files (Attachments):
NOTE: Please attach the following documents for Micro Enterprises:
[NOTA: Sila lampirkan dokumen berikut untuk Micro Enterprise:]

Sole Proprietorship [Perniagaan Tunggal]

Upload Full SSM Document [Muat naik Sijil SSM yang lengkap]

I. Document with the end date until March 2022 [Muka surat dengan tarikh berakhir sehingga Mac 2022]

Max. file size: 15 MB.

File

II. Document with the details of business information [Muka surat butiran maklumat perniagaan]

Max. file size: 15 MB.

File

III. Document with the details of business owner [Muka surat butiran pemilik perniagaan]

Max. file size: 15 MB.

Upload EPF Statement or Annual Financial Statement [Muat Naik Penyata KWSP/Penyata Tahunan Kewangan]

- If EPF Statement [Penyata KWSP]: less than 5 full-time employees [kurang 5 pekerja sepenuh masa]
- If Annual Financial Statement [Penyata Tahunan Kewangan]: less than RM300,000/year [kurang RM300,000/tahun]

Max. file size: 15 MB.

Sdn Bhd & PLT Business [Perniagaan Sdn Bhd & PLT]

Upload both Form 9 and Form 14 [Muat naik Borang 9 dan Borang 14]

Upload Form 9 [Muat naik Borang 9]

Max. file size: 15 MB.

Upload Form 14 [Muat naik Borang 14]

Max. file size: 15 MB.

SECTION C: DECLARATION [BAHAGIAN C: PENGAKUAN]

Name of Applicant [Nama Pemohon](Required)

Name as per NRIC [Nama seperti dalam NRIC]

Date [Tarikh](Required)

Signature [Tandatangan](Required)

*To sign again, please click the refresh symbol at the bottom right. [Untuk menandatangani sekali lagi, sila klik simbol refresh di sebelah kanan bahagian bawah.]

SME Corp Malaysia reserves the right to reject the application / withdraw the assistance provided if the information submitted is found to be false or misleading.
[SME Corp. Malaysia berhak untuk menolak permohonan / menarik balik bantuan yang telah diberikan sekiranya didapati maklumat yang dikemukakan adalah palsu atau mengelirukan.]

Micro Connector Program [Program Micro Connector]
The Micro Connector program is an initiative under SME Corp. Malaysia aims to provide assistance to micro-enterprises in setting up and running businesses more effectively as well as training inclusive communities such as youth, women, B40 and others to acquire new skills and subsequently to generate income through entrepreneurship.
[Program Micro Connector adalah merupakan satu inisiatif di bawah SME Corp. Malaysia bertujuan untuk memberikan bantuan kepada perusahaan mikro dalam menubuhkan dan menjalankan perniagaan dengan lebih efektif serta melatih komuniti golongan inklusif seperti belia, wanita, B40 dan lain-lain untuk mendapatkan kemahiran baharu dan seterusnya untuk menjana pendapatan melalui keusahawanan.]

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