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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

* Mandatory fields

Citizenship
Do you give permission for Total South Africa to perform a credit check? *
CONTACT DETAILS
Files must be less than 2 MB.
Allowed file types: jpg jpeg png pdf.
EDUCATIONS AND QUALIFICATIONS
Graduation Date
Files must be less than 2 MB.
Allowed file types: jpg jpeg png pdf.
EMPLOYMENT/ WORK HISTORY
Previous employment
Date commenced
Date resigned
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
Files must be less than 2 MB.
Allowed file 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?
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.
Criminal record
Do you have any criminal records
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx xls xlsx.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx xls xlsx.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx xls xlsx.
Commencement date
 
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