LICENSED APPLICATOR APPLICATION
If you already have an established business - Click here
Personal Information
please tick the applicable box or fill in the applicable fields, * = compulsory fields
Surname*
First Names*
ID Number*
Nationality
Current Occupation
Married? Yes No
Number of dependants
Planned Trading Name of business
Registration number if applicable
Telephone Numbers*
E-mail address*
Website if applicable
Tel: Fax: Cell:
Do you plan to do business as a:
Company
Close corporation
Trust
Sole Proprietor
Please describe your main line of products and/or services that you plan to market
Street address from which business* is/will be operating
Postal Address of business
Registered for VAT?
YES VAT Reg No:
NO
Owners of the business:
Name*
Name
Language Preference/ Taalkeuse
Enghlish
Afrikaans
In short, please describe your business plan: