BBCBE Member Application

1

Personal Information Representative

* Username

* Email Address

* Password

Strength: Very Weak

* First Name

* Surname

* Title(Mr, Mrs, Ms)

Gender

Male

Female

* Date of Birth

* ID/Passport Number

* Mobile

Telephone

Home Address

Member City

* Country

* Province/State

* Postal Code

2

Company Information

* Company Name

* CIDB CRS Number

* CIDB Category Of Registration

NHBRC Reg Number

* Income Tax Number

* VAT Number

* PAYE Number

* Skills Dev Levy Number

* Occupational Health & Safety

3

Empowerment Information

* Black ownership %

* Black Women Ownership %

* Black Youth Ownership %

* People Living With Disabilities Ownership %

* Employee Ownership %

* Community/education Trust Ownership %

* Percentage Of Blacks In Senior Management %

* Percentage Of Black Women In Senior Management %

* Percentage Of Black Youth In Senior Management %

* Percentage Of Blacks In Middle Management %

* Percentage Of Black Women In Middle Management %

* Percentage Of Black Youth In Middle Management %

4

Partners Demographics

* No. Of Partners

* % Of Black Partners

* % Of White Partners

* % Of Youth Partners

* % Of Professionally Registered Partners

* % Of (non-) / South African Partners

* Upload Company Registration Documents(PDF)