Become a Dealer (New Station)

Retail Dealer Selection Process-Application Form

(Please insert all the details required on the application form-incomplete/missing information would lead to immediate discarding of the application)

If you are applying for an existing or new service station opportunity, your application form must be accompanied by a comprehensive business plan for the service station your are applying for.
The application form and business plan must be submitted to: -
The Dealer Placement Specialist
TotalEnergies South Africa (Pty) Ltd
P O Box 579
Saxonwold
2132

Citizenship
Do you give permission for Total South Africa to perform a credit check? *
CONTACT DETAILS
One file only.
2 MB limit.
Allowed types: jpg, jpeg, png, pdf.
EDUCATIONS AND QUALIFICATIONS
One file only.
2 MB limit.
Allowed types: jpg, jpeg, png, pdf.
EMPLOYMENT/ WORK HISTORY
Previous employment
Do you have experience in the following areas?
Handling Cash
Staff management and Recruitment
Analyzing cash flow
Stock control
Retail/ selling to the public
Working with financial statement
Working on weekends
FINANCIAL INFORMATION
One file only.
2 MB limit.
Allowed types: jpg, jpeg, png, pdf, docx.
Please provide the following Financial infromation
Assets
Liabilities
REFERENCES
Please provide details of a business/work reference
GENERAL INFORMATION
Drivers licence
Do you hold a valid South African drivers licence?
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.
Criminal record
Do you have any criminal records
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf.
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf.
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx, xls, xlsx.
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx, xls, xlsx.
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx, xls, xlsx.