Young Entrepreneurs Program Application Form
Johannesburg 2025 Applications
Details of the child
*
First Name
Last Name
Choose one:
*
This is my first time to attend YEP
I am a returning member of YEP
I have graduated from YEP
Identity Number (A photocopy of ID or birth certificate must accompany application)
*
Upload copy of the child’s ID/birth certificate here:
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Please also upload a current photo of the child(headshot).
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Gender of the child
Male
Female
Current Age
*
Mother/Guardian Name & Surname
*
Street Address
*
City, State, Zip
*
E-mail of the parent
*
Phone Number: Parent/Guardian
*
-
Area Code
Phone Number
Occupation of the parent
*
Emergency Contact if Parent Unreachable
*
Relationship with the emergency contact
Phone (Emergency Contact)
*
Have the child received certification in any of the following?
Personal Development Skills
Leadership Skills
Entrepreneurial Skills
Study attitude program
Does the child have previous background in selling?
Yes
No
If yes, what have she/he sold and how was their experience?
*(filled by child) Please describe why you wish to be a part of the Young Entrepreneurs Program, what do you think you may achieve by participating in this program and how excited are you to begin?
Medical History
Does the child have any medical, emotional, or mental health conditions?
No
Yes
If yes, please describe:
Does he/she take any medications?
Yes
No
If yes, please list medication, reason and any side effects:
Have she/he had any serious illness, injuries, or medical operations in the last three years? Should we do exercises that may harm the child
Yes
No
If yes, please list:
Have she/he had any physical handicaps or conditions preventing you from performing any type of activity?
No
Yes
If yes, please list:
Does the child have any food allergies?
No
Yes
If yes, please list:
Does the child have any disabilities?
No
Yes
If yes, please list:
Education
School Name
*
Grade
*
Favorite subject
Sport/activity participating in:
Which program are you registering for?
Nurturing Entrepreneurial Mindset
Confidence & Public Speaking
The information contained in this application is correct to the best of my knowledge.
No
Yes
How did you find out about us?
As a parent/guardian I have carefully read the foregoing release and know the contents thereof and I sign this release of my own free act. This is a legally binding agreement which I have read and understand. I fully support my child to take part in this program and will support him/her in this journey
Yes
No
Payment Details
Price: R750 p/c for per program FNB, Acc No: 63107564014, Acc Holder: MNI BUSINESS CONSULTING, Branch Code: 250 424, Reference: Name&Surname_YEP, Provide POP via admin@wibf.co.za | WhatsApp: 081 352 7470| Call: 074 363 2332
Thank you for your interest in being a part of the YEP Team!
By submitting this form you give us permission to contact you to provide you with a calendar of the programs.
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