GenSafe Workplaces - Enrolment Form
Please complete our form if you would like to sign up for our free foundational programme either for yourself or on behalf of an organization to enable us to customise the programme for you and/or to provide you with the log-in details for exclusive access to our online learning platform.
You may contact us directly at
if you have any queries on our programme or our organisation.
1. State your first name.
2. State your last name.
3. What is your gender?
4. What is your age?
24 & below
25 to 29
30 to 39
40 & above
5. What is your nationality.
Singaporean / Singapore Permanent Resident
6. State your LinkedIn profile link.
7. Are you currently employed?
8. State your industry.
9. What is your designation?
Corporate Social Responsibility
Diversity & Inclusion
10. Are you enrolling for yourself or on behalf of an organisation?
11. If you are enrolling for an organisation, state the organisation's name.
12. Do you require our assistance in presenting the GenSafe Workplaces programme to your organisation's management/representative?
13. If yes to Question 12, select topic(s) you would like us to address:
Foundational framework of Recognise, Respond & Refer
Business case for a Domestic Violence & Abuse
Customized training programmes for employees
Creation of corporate toolkit (i.e. posters, flyers, leaflets, etc) for employees
Review of existing personnel policies and provide recommendation(s)
Creation of a Domestic Violence & Abuse workplace policy
All relevant topics to GenSafe Workplaces programme
13. Would you like us to contact you for:
Enrol in the GenSafe Workplaces foundational programme
Present GenSafe Workplaces programme to your organisation's management/representative
Present a learning session to your members
Invitation to all related events for GenSafe Workplaces programme
Invitation to other events curated by United Women Singapore
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This form was created inside of United Women Singapore.