Run with It - Supply Chain Equity Programme

Run with It - Supply Chain Equity Programme

Programme Application Form
Other details

ID NumberAge
Name

First NameLast Name
Other Details

NationalitySA Race Classification
Email & Social Media

EmailLinked In Profile e.g https://www.linkedin.com/in/nicci-scott-anderson-84b08318
Applicant Residential Physical Address

Street Address

Street Address Line 2

CityProvince

Postal Code
27 Phone Number
Please enter a valid phone number.

Business Details

Business Trading NameReg No:
Business Information

Nature of Business e.g Commercial Trucking/LogisticsAnnual Turnover
What sector does the business particpate in?List top 2 to 3 clients
Products

Types of products/services soldRegion your product/service is sold in
Location of Business

Business Location/sNumber of staff employed in your business
Do you have access to a Laptop/Tablet and data?
Company information

How long has your business been operational?B-BBEE Status of Business
What is your role in the businessList your Job title
File Upload - Please upload your CIPC Document, ID copy, Share certificate, B-BBEE Certificate

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Your Coaching Needs - Describe the initial support you seek to grow your business.
Your Consent

I acknowledge that by completing this form I will not be automatically entered into the Run with It Programme.

I request business coaching/mentorship service from Commercial Transport Academy or its Resource Partner. I agree to cooperate should I be selected to participate in surveys designed to evaluate Commercial Transport Academy services. I permit Commercial Transport Academy or its Resource Partners the use of my name and address for surveys and information mailings regarding Commercial Transport Academy products and services
I hereby consent

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I understand that any information disclosed will be held in strict confidence. (Commercial Transport Academy will not provide your personal information to commercial entities without your consent.) I authorize Commercial Transport Academy to furnish relevant information to the assigned management coach/mentor(s) and sponsors of the programme including for reporting purposes. I further understand that the coach/mentor(s) agree not to: 1) recommend goods or services from sources in which he/she has an interest, and 2) accept fees or commissions developing from this counseling relationship. In consideration of the coach/mentor(s) furnishing management or technical assistance, I waive all claims against Commercial Transport Academy personnel, and that of its Resource Partners and host organizations, arising from this assistance.
Disclaimer

Use of Information: The information in this form is to be provided by individuals and business seeking technical assistance services from Commercial Transport Academy or an Commercial Transport Academy Resource Partner. The information is collected to help Commercial Transport Academy's continuing improvement of business coaching/mentorship programmes, to ensure effective oversight and management of entrepreneurial development programmess and grants, and to meet Congressional and Executive Branch reporting requirements. The form should be submitted at the site of the Commercial Transport Academy. The CTA shall comply with the POPI Act regarding information received.
All candidates:
- will be selected upon meeting the required criteria
- must have a laptop and data (internet)
- submissions open 1 August 2022
- all documents required must be uploaded
- all unsuccessful candidates will be notified
List the company/person who referred you to this programme.
Should be Empty: