PLEASE FILL OUT THE ENTIRE FORM SO THAT WE MAY BE BETTER ABLE TO ASSIST YOU - THANK YOU
Family Name:
First Name:
Postal Address:
E-Mail:
Tel:
1.         Age in years:
2.         Marital Status:
How many persons do you support, if any:
3.         Educational Background (please list highest first:
Certificate/Diploma/Degree
Year
Institution
4.         Have you attended any previous workshops, seminars or training courses?
YES
 NO
If answer to above is Yes, please indicate details below:
Course Details
Year
Institution
5.         Did you ever serve as the leader of a group?
 NO
YES
If YES please indicate your position
YES
6.         Did you ever have a family business?
NO
YES
If YES did you work in the family business?
NO
7.         Which type of business do you intend to start or expand?
i.         Business description:
ii.         Business Location:
iii.         Estimated monthly sales revenue:
iv.         How much money will you need to start your business?
v.         Please indicate how you intend to finance your business?
 Own Funds
Family/Funds
Loan
8.         If you are employed, please explain how you will manage your business
9.         Please indicate which course(s) you would like to attend by making your selection from the last column below:
COURSE TITLE
COURSE CENTRE
If the times indicated are not suitable, please state when you can be
available for the intended course
10.         Please list the names of two local referees below (No Relatives)
Name:
Address:
Tel:
Name:
Address:
Tel:


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