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Workshop Registration Form for Burgersfort
First Name:
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Surname:
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ID Number:
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Age:
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Gender:
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Male
Female
Cell Number:
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Email Address:
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Confirm Email Address:
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Where did you hear about Pitch & Polish?:
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Newspaper Advert
Newspaper Article
Radio Advert
Radio Interview
SMS
Email
Friend told you
Poster
Flyer
Organisation
Other
If other, please specify:
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Which organisation?
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Which town / area do you live in?:
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Which of the following most apply to you?:
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I have an existing business
I have a business idea
I would like to have my own business but don't yet have an idea
Other
What is the core function of your business?
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What is your business idea?
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Please specify:
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Kindly indicate your preferences below:
Nedbank may contact me regarding the variety of small business offerings they have available
Engen Petroleum may contact me should my business / idea align with their supply chain requirements
Yes, please notify me of any future entrepreneurial focused events
Yes, Raizcorp may contact me regarding offerings they have for entrepreneurs in my area
Yes, the local partners may contact me regarding the support they offer
Click here to the read the workshop terms and conditions
Kindly confirm:
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Yes, I have read the terms and conditions