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Entry Form for Vereeniging
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
Which organisation?
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If other, please specify:
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Which town / area do you live in?:
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Which of the following most applies to this entry?
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I am entering with a existing business
I am entering with a business idea
Please give a short description of your business opportunity or business idea:
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Please describe how you would make money from this business opportunity or business idea:
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Why should we believe you?:
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Describe your current business challenges or foreseeable challenges:
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What has been the biggest personal challenge in your life and how did you deal with it?:
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Describe your most inspirational experience and how it affected your life:
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Kindly indicate your preferences below:
Nedbank may contact me regarding the variety of small business offerings they have available
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Engen Petroleum may contact me should my business / idea align with their supply chain requirements
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Yes, please notify me of any future entrepreneurial focused events
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Yes, Raizcorp may notify me of any offerings they have that support entrepreneurs in my area
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Yes, the local partners may contact me regarding the support they offer
Click here to read the competition terms and conditions
Kindly confirm:
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Yes, I have read and understood the terms and conditions of entry and the competition
Yes, I understand that I will only be contacted if my entry is chosen