Franchise Opportunities

first name & surname physical address

telephone number (home) telephone number (work) cellphone number email address do you have access to a computer and email / internet? are you eligible to work in south africa? are you a south african citizen? date of birth gender? marital status? do you have children? if yes, what are their ages? do you have a current drivers licence? if yes, do you have the use of a car? I am computer literate and proficient in the use of Microsoft Excel, Word and Outlook and I have daily access to a computer and internet connection.

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)

company details / dates employed / position / type of business / reason for leaving company details / dates employed / position / type of business / reason for leaving company details / dates employed / position / type of business / reason for leaving company details / dates employed / position / type of business / reason for leaving company details / dates employed / position / type of business / reason for leaving

for employment references, may we approach:

your present employer? your former employer(s)?

work related: company & address / contact person / designation / telephone numbers work related: company & address / contact person / designation / telephone numbers personal: company & address / contact person / designation / telephone numbers personal: company & 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 & why do you want to become a franchisee? where do you intend offering the experi-maatjies / experi-buddies programme & what is your proposed starting date? are you currently employed? full-time? part-time? please describe the work that you currently do how many hours per week do you devote to your current work? hrs / week how many hours per week can you invest in experi-maatjies / experi-buddies? hrs / week are you prepared to leave your present employment to present the experi 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

have you ever been, or are you currently under a sequestration order, liquidated or undergoing an administration process to rehabilitate your finances?

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.

I accept