Working in our stations

You have real business experience and knowledge? You can manage a team and cope well under pressure? To become a dealer please get in touch.

Name of site ^*

Province ^*

CONTACT DETAILS

Telephone number (Home) ^*

Telephone number (Work) ^*

Cellphone number ^*

Fax number ^*

South Africa ID number ^*

Attach a certified SA ID copy ^*

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Do you have the support of your immediate family? ^*

Are you prepared to accept long and irregular working hours? ^*

EDUCATIONS AND QUALIFICATIONS

Name of high school ^*

Date attended ^*

Name University/College ^*

Graduation Date ^*

Other qualifications ^*

Attach Certificates ^*

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EMPLOYMENT/ WORK HISTORY

Current employer ^*

If you are self employed, please describe the nature of your business ^*

Address ^*

Position/ title ^*

Current Salary (per annum) ^*

Annual bonus ^*

Other company benefits ^*

Previous employment

Employers name ^*

Address. ^*

Previous position/ title ^*

Date commenced ^*

Date resigned ^*

Main responsibilities ^*

FINANCIAL INFORMATION

What are your prime business objectives for applying for this Service Station? ^*

How much of your own capital do you intend to invest in the business? ^*

Attach proof of own capital contribution ^*

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From which source? ^*

What annual income are you expecting to earn? ^*

How many hours per day are you willing to spend at the service station? ^*

Will you be involved in other business ventures? ^*

If so, elaborate? ^*

Should your application for a TSA Dealership be unsuccessful, what are your future plans? ^*

Have you or you spouse been involved in bankruptcy and insolvency proceedings? If yes, give full details ^*

Have you or spouse ever had a judgement in respect of bad debt recorded against you? If yes, please provide full details ^*

Please provide the following Financial infromation

Annual wage/ Salary after tax ^*

Annual bonus/ commision ^*

Annual dividends ^*

Annual property income ^*

Other annual income (Details) ^*

Total annual income ^*

Annual monthly bonds/rent repayments ^*

Annual monthly loan repayments ^*

Other annual repayments (Details) ^*

Total annual present expenditure ^*

Assets

Cash in the bank ^*

Shares/ Investments ^*

Properties ^*

Motor vehicles ^*

Business value (If any) ^*

Other assets ^*

Liabilities

Overdraft ^*

Total Creditors ^*

Total bond outstanding ^*

Hire purchases, lease repayments ^*

Other liabilities ^*

REFERENCES

Please provide details of a business/work reference

Name ^*

Job title ^*

Company name ^*

Address ^*

Contact numbers ^*

GENERAL INFORMATION

Drivers licence

Do you hold a valid South African drivers licence?

Yes ^*

No ^*

if yes, please attached a copy ^*

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2 MB limit.
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Criminal record

Do you have any criminal records

Yes ^*

No ^*

If yes, please provide full details ^*

Attach CIPC company documents ^*

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Attach company tax clearance certificate/pin ^*

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Attach updated resume/CV ^*

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Additional document ^*

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Additional document 2 ^*

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2 MB limit.
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Additional document 3 ^*

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2 MB limit.
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Commencement date ^*

Working in our petrol stations

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