Registration: Accel Enterprise Development Programme

Applicant Information
Name &
Surname: Date:
Name Surname M.I.
Phone: ( ) E-mail Address:

Cell phone: ID Number:

Male Female Racial Black White Colored Indian SA Other (Please specify)
Gender: Group: Nationality:

Business Information
Business
Name: Websit URL:

What does your

business do?

0 0-2 Years 2+ Years

How long have you been in business?
0 1-5 5+
How many people do you employ?
0 1-50k 50k+
What is your monthly turnover?
YES NO
Is this your first business venture?
YES NO
Do you have business partners?
YES NO
Do you have a business plan?
YES NO
Does your business operate from an office?

Motivation

Why should we invest in you?

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application is successful, I understand that false or misleading information in my application or interview
may result in my release.

Signature: Date: