FIRST Name & SURNAME PHYSICAL ADDRESS TELEPHONE NUMBER (HOME) TELEPHONE NUMBER (WORK) CELLPHONE NUMBER E-mail address RequiredThis is not a valid email address

Do you have access to a computer and e-mail / internet? Yes No

ARE YOU LEGALLY ELIGIBLE TO WORK IN SOUTH AFRICA? Yes No

ARE YOU A SOUTH AFRICAN CITIZEN? Yes No
IF NOT, PLEASE STATE YOUR NATIONALITY DATE OF BIRTH

GENDER Male Female

Engaged Married Separated Divorced Widowed

DO YOU HAVE CHILDREN Yes No
IF YES, WHAT ARE THEIR AGES? DO YOU HAVE A CURRENT DRIVER'S LICENCE Yes No

IF YES, DO YOU HAVE THE USE OF A CAR Yes No

Language	Spoken	Written
	Excellent Good Fair	Excellent Good Fair
	Excellent Good Fair	Excellent Good Fair
	Excellent Good Fair	Excellent Good Fair

COLLEGE / UNIVERSITY (NAME & LOCATION / SUBJECTS / DATES YOU ATTENDED / QUALIFICATION SECONDARY (NAME & LOCATION / SUBJECTS / DATES YOU ATTENDED / QUALIFICATION OTHER (NAME & LOCATION / SUBJECTS / DATES YOU ATTENDED / QUALIFICATION

01. COMPANY NAME & ADDRESS / DATES EMPLOYED / POSITION / TYPE OF BUSINESS / REASON FOR LEAVING 02. COMPANY NAME & ADDRESS / DATES EMPLOYED / POSITION / TYPE OF BUSINESS / REASON FOR LEAVING 03. COMPANY NAME & ADDRESS / DATES EMPLOYED / POSITION / TYPE OF BUSINESS / REASON FOR LEAVING 04. COMPANY NAME & ADDRESS / DATES EMPLOYED / POSITION / TYPE OF BUSINESS / REASON FOR LEAVING 05. COMPANY NAME & ADDRESS / DATES EMPLOYED / POSITION / TYPE OF BUSINESS / REASON FOR LEAVING FOR EMPLOYMENT REFERENCES, MAY WE APPROACH:
YOUR PRESENT EMPLOYER? Yes No
YOUR FORMER EMPLOYER(S) Yes No

WORK RELATED (Company name & Address / contact person / designation / telephone numbers WORK RELATED (Company name & Address / contact person / designation / telephone numbers PERSONAL (Company name & Address / contact person / designation / telephone numbers PERSONAL (Company name & Address / contact person / designation / telephone numbers HOBBIES & INTERESTS

WHERE DID YOU FIRST LEARN ABOUT EXPERI-MAATJIES / EXPERI-BUDDIES? WHAT ATTRACTED YOU TO EXPERI-MAATJIES / EXPERI-BUDDIES AND WHY DO YOU WANT TO BECOME A FRANCHISEE? WHERE DO YOU INTEND OFFERING THE EXPERI-MAATJIES / EXPERI-BUDDIES PROGRAMME AND WHAT IS YOUR PROPOSED STARTING DATE? ARE YOU CURRENTLY EMPLOYED? IS THIS FULL-TIME OR PART-TIME? PLEASE DESCRIBE THE WORK THAT YOU CURRENTLY DO HOW MANY HOURS PER WEEK DO YOU DEVOTE TO YOUR CURRENT WORK? HOW MANY HOURS PER WEEK CAN YOU INVEST IN EXPERI-MAATJIES / EXPERI-BUDDIES? ARE YOU PREPARED TO LEAVE YOUR PRESENT EMPLOYMENT TO PRESENT THE EXPERI-MAATJIES / EXPERI-BUDDIES PROGRAMME FULL-TIME?

WHAT EXPERIENCE DO YOU HAVE AS A TEACHER OR IN DEALING WITH CHILDREN? WHAT ARE THE CHALLENGES OF EDUCATION IN SOUTH AFRICA TODAY?

DO YOU HAVE ANY CRIMINAL CONVICTIONS? Yes No

HAVE YOU EVER OR ARE YOU CURRENTLY UNDER A SEQUESTRATION ORDER, BEEN LIQUIDATED OR UNDERGONE/ING AN ADMINISTRATION PROCESS TO REHABILITATE YOUR FINANCES? Yes No

The information provided on this application is true and correct and complete. Any misstatement or omission of fact on this application may result in losing my eligibility to become a Experi-Buddies / Experi-Maatjies Franchisee. I understand that acceptance of this application does not create a contractual obligation upon Experi-Buddies / Experi-Maatjies to recruit me as a Franchisee

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