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Empowering Her Business Awards – Applications

GENERAL INFORMATION

Where did you hear about the Empowering Her Campaign – 2024 *

Social Media
Hollywood Website
Nomzamo Mbatha Lighthouse Foundation
Word of Mouth
Other

For Other, please state where

Are you currently on another ESD programme? *

Yes
No

What is the name of the programme you are part of?

Have you ever been accepted for another ESD programme? *

Yes
No

What was the name of this programme?

SECTION A: COMPANY DETAILS

Registered Business Name *

Business Trading Name *

Name of Contact Person *

Email *

Contact Number *

Business Registration Number *

VAT Registration Number

Business Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Job Title/Position in the business *

Give a brief description of your business, including major business milestones achieved to date *

Detail paragraph Minimum 200 Words

Nature of the business: List the core services your company provides. *

SECTION B: SIZE OF THE COMPANY – ANNUAL TURNOVER

What is the annual turnover for your business over the last 3 years? (Excl. VAT) *

How many staff members (employees) do you employ? *

Full Time *

Part Time *

How many of the above have joined your company in the last year? *

Full Time *

Part Time *

SECTION C: OWNERSHIP

Contact 1

Name *

First

Last

Contact Number *

Position in the company

Mention Position

Number of years with your company *

Race

Qualification *

Ownership % *

% Time devoted to the company *

Contact 2

Name

First

Last

Contact Number

Position in the company

Mention Position

Number of years with your company

Race

Qualification

Ownership %

% Time devoted to the company

SECTION D: BUSINESS TRACK WORKING RECORD WITHIN THE LAST TWO YEARS

Contract 1

Description of contract

Status (prime/ sub/ labour only)

Contact Person

First

Last

Contact Number

Total Value of contract

Your business share

Number of employees working on contract

Full time/Part time

Expected date of completion

Contract 2

Description of contract

Status (prime/ sub/ labour only)

Contact Person

First

Last

Contact Number

Total Value of contract

Your business share

Number of employees working on contract

Full time/Part time

Expected date of completion

SELECTION CRITERIA

Community Impact: If successful, can the proposed project create economic opportunity in the area, and make a difference in the lives of underserved populations? *

Innovation: Does the project present unexpected solutions to the target population’s needs? *

Feasibility: Is the project plan well thought-out, and the team well-equipped to execute on it? *

Creativity: What makes your business unique? *

State what are your business requirements *

CHECKLIST

My company profile *

Click or drag a file to this area to upload.

Valid B-BBEE certificate/ EME/ QSE Sworn Affidavit as per the Codes of Good practice *

Click or drag files to this area to upload. You can upload up to 4 files.

Company Registration documents *

Click or drag files to this area to upload. You can upload up to 4 files.

DECLARATION

Declaration Submit *

I hereby warrant that: The information provided herein is true and correct to the best of my knowledge. I understand that this declaration is binding on my conscience, and that any inaccuracy or misrepresentation of facts may void the registration of the business.

Information Processing Consent *

I further consent to the processing of my/the business

NPC registration number: 2019/147154 /08
PBO approved under Section 18A (1) (A)

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GENERAL INFORMATION

SECTION A: COMPANY DETAILS

SECTION B: SIZE OF THE COMPANY – ANNUAL TURNOVER

SECTION C: OWNERSHIP

SECTION D: BUSINESS TRACK WORKING RECORD WITHIN THE LAST TWO YEARS

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