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Partner application
2019-08-22T15:29:40+02:00
Online Partner Application ...
1
Criteria, Consent & Contact
2
Company Details
3
Directors/Members/Shareholders
4
Location & Landlord
5
Target Market & Products/Services
Qualifying Criteria & Consent
Is the business 3 years or older?
*
yes
no
Do you have the necessary mandate to apply?
*
yes
no
Annual Turnover
*
under R5 million
R5 - R10 million
R10 - R100 million
R100 - R500 million
over R500 million
I agree to the Terms & Conditions
*
yes
no
You need to have the appropriate mandate & accept our T&Cs
Are there any past or pending legal actions against you or your companies?
*
yes
no
Are there any past or pending criminal charges against you or your companies?
*
yes
no
Without a satisfactory explanation & proof - we're unlikely able to assist you.
What does your business do?
*
I advise SMEs
I sell products to SMEs
Average deal size
*
Quotes per month
*
Contact Person
First Name
*
Last Name
*
designation
*
Email
*
Work Phone
*
Mobile Phone
*
Company Details
I'm applying as
*
Close Corporation
Private Company
Trust
Registered name
*
Trading name (if applicable)
Year established
*
Registration number
*
VAT number
Website
*
Number of staff
*
BEE level
*
Industry Sector
*
BEE shareholding
*
Auditor/Accountant/System
Name of firm
*
Contact person
*
Phone
*
Email
*
Accounting package
*
Directors/Members/Shareholders/Owners
Legal_Natural
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of legal entity
*
Name of natural person
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Add another director/member/shareholder
Add another director/member/shareholder
Legal_Natural
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of legal entity
*
Name of natural person
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Add a 3rd director/member/shareholder
Add a 3rd director/member/shareholder
Legal_Natural_3
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of legal entity
*
Name of natural person
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Add a 4th director/member/shareholder
Add a 4th director/member/shareholder
Legal_Natural_4
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of legal entity
*
Name of natural person
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Add a 5th director/member/shareholder
Add a 5th director/member/shareholder
Legal_Natural_5
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of legal entity
*
Name of natural person
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Add a 6th director/member/shareholder
Add a 6th director/member/shareholder
Legal_Natural_6
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of natural person
*
Name of legal entity
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Add a 7th director/member/shareholder
Add a 7th director/member/shareholder
Legal_Natural_7
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of natural person
*
Name of legal entity
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Add a 8th director/member/shareholder
Add a 8th director/member/shareholder
Legal_Natural_8
*
Legal entity
Natural person
Detail of Ownership
*
Director
Director & Shareholder
Member
Shareholder
Name of natural person
*
Name of legal entity
*
Email
*
Phone
*
Birthdate
*
Race
*
Race (for statistical purposes only)
black
coloured
indian
asian
white
other
ID number
*
Gender
*
male
female
Shares
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Location & Landlord
Primary business location
*
Street Address
City
Province
ZIP / Postal Code
Landlord's Address
*
Street Address
City
Province
ZIP / Postal Code
Landlord's name
*
Landlord's phone
*
Do you have more than one business premises?
*
yes
no
Landlord's email
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Landlord's Address
*
Street Address
City
Province
ZIP / Postal Code
Landlord's name
*
Landlord's phone
*
Do you have a 3rd business premises?
*
yes
no
Landlord's email
*
Address
*
Street Address
City
Province
ZIP / Postal Code
Landlord's Address
*
Street Address
City
Province
ZIP / Postal Code
Landlord's name
*
Landlord's phone
*
Landlord's email
*
Target Market
Target Market/s
*
Individuals
Micro (less than 10 staff)
Small & Mid sized (10 to 500 staff)
Enterprise (more than 500 staff)
Public sector
Products/Services
Products/Services
*
Machinery
Technology equipment
Software
Specialised equipment
Hardware
Fit-out
Other
