Bizmod

User Details

ID Type

ID Number

First Name

Middle Name

Surname

Previous surname (if applicable)

Date of Birth

Race

Learner Title

Nationality

Citizenship status

Home Language

Socio Economic Status

Disability Status

Gender

Contact Details

Province

House No./Complex Name

Street Name

Surburb

Postal Address

Postal Town/City

Box Code

Cell Number

Alternate Cell Number

WhatsApp Number

Home Phone Number

Business Number

Postal Code

Street Code

Business Details

Name of Registered Entity

Entity Type

Incorporation Number and Date

Ownership / shareholder structure

BEE Status (options)

% Black owned

% Female owned

Business Physical Address

Business Postal Address

Business Contact Number/s

Which of the listed focus areas / sectors would you say your enterprise aligns to most closely?

What phase is your business currently experiencing?

What is your current average monthly revenue?

What % of current average monthly revenue is profit?

What is the average monthly turnover of the company? (last 6 months)

How many regular clients do you currently have?

Your team: Current number of fulltime employees?

Your team: Current number of parttime employees?

Which Accounting software do you use to manage and track your business finances?

Have you participated / are you currently involved in a business development programme / a member of an business incubator?

If you answered yes to the above, specify the programme/incubator/accelerator

What is the next strategic goal for your enterprise?

Educational information

Highest School Qualification

Highest Qualification

Last School

Last School EMIS

Last School Year

Statistical information

STATSSA Area This field is required.

Municipality This field is required.

Town/City

Postal Code

Emergency Contact Details

Next of kin first name

Next of kin surname

Relationship to candidate

Contact number

Required information

C.V.(PDF format only)

Proof of disability (Only PWD Applicants)

Certified Copy of ID Document

Certified Copy of Matric Certificate (or final grade 11 progress report)

Certified Copy of other qualifications

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