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Referral Number
Company Type/Structure
-- Select Company Type/Structure --
(Pty) Ltd
CC
NGO
Paraststal
Partnership
Public Company LTD
Section 21 Company
Sole Proprietor/Individual
Trust
Company Name
Membership Number
Company VAT Registration Number
Office Number
(eg. XXX XXX XXXX)
Mobile Number
(eg. XXX XXX XXXX)
General Email
Web Address
Physical Address
Physical Address Postal Code
Postal Address
Postal Address Postal Code
Year Business Established
Annual Turnover
(to nearest R 1/2 million)
SETA SECTOR CLASSIFICATIONS:
In which industry is your business active?
-- Select SETA Sector --
Membership Classification*
-- Select Option --
Womens Desk
Entry Level (2 yrs only)
1-10 employees
11-30 employees
M16 (Affiliated)
31-50 employees
51-80 employees
81-100 employees
101-150 employees
151-250 employees
251-1000 employees
1001 employees & up
Corporate Partners
Platinum Members
Patron Members
Black Owned? (Check if yes)
Woman Owned? (Check if yes)
Youth Owned? (Check if yes)
How did you hear about the Chamber?
-- Select Option --
Contacted by Denise Lightfoot
Visited your website
Referral
Attended an event
