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. You must have JavaScript enabled to use this form. Name of site * Province * PERSONAL DETAILS Citizenship South Africa * Namibia * Botswana * Lesotho * Swaziland * Angola * Malawi * Zambia * Zimbabwe * Mozambique * Other * First Name * Surname * Physical address * Postal address * Email * What is your current job position * Do you give permission for Total South Africa to perform a credit check? * Yes * No * CONTACT DETAILS Telephone number (Home) * Telephone number (Work) * Cellphone number * Fax number * South Africa ID number * Attach a certified SA ID copy * Upload One file only.2 MB limit.Allowed types: jpg, jpeg, png, pdf. 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 * Upload One file only.2 MB limit.Allowed types: jpg, jpeg, png, pdf. 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 * Do you have experience in the following areas? Handling Cash Yes * No * Staff management and Recruitment Yes * No * Analyzing cash flow Yes * No * Stock control Yes * No * Retail/ selling to the public Yes * No * Working with financial statement Yes * No * Working on weekends Yes * No * 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 * Upload One file only.2 MB limit.Allowed types: jpg, jpeg, png, pdf, docx. 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 * Upload One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, pdf, doc, docx. Criminal record Do you have any criminal records Yes * No * If yes, please provide full details * Attach CIPC company documents * Upload One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, pdf. Attach company tax clearance certificate/pin * Upload One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, pdf. Attach updated resume/CV * Upload One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, pdf, doc, docx. Additional document * Upload One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, pdf, doc, docx, xls, xlsx. Additional document 2 * Upload One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, pdf, doc, docx, xls, xlsx. Additional document 3 * Upload One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, pdf, doc, docx, xls, xlsx. Commencement date * Submit Working in our stations Working in our petrol stations Join us