Accelerator Application Form

Accelerator Application Form
By completing this form, you agree to this information being used to unlock commercial opportunities with prospective customers as part of the facilitation of the Accelerator. For more information, please download this info pack.
Company Name*
What is your business entity classification?*
Name*

First NameLast Name
Designation*
e.g. CEO, Managing Director, COO, etc.
Email*
example@example.com
Contact Number*
Please enter a valid phone number.
Alternative Contact Number
Please enter a valid phone number.
Website
If you have an active website.
Type of company*

ManufacturingServicesManufacturing and ServicesOther
What sector do you predominantly work in?

AutomotivesChemicalsClothing, Textiles, Footwear and Leather (CTFL)FurnitureFood & BeveragesOther
How many years has this business been trading?*
Which locations do you currently have operations?*

KwaZulu-NatalGautengFree StateMpumalangaLimpopoNorth WestNorthern CapeEastern CapeWestern CapeOutside of South Africa
Which province/s are you based in?*
Head Office Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide the number of full-time equivalent employees*

Please provide your number of full-time equivalent employees*

	No. of full-time equivalent employees
Office based
Factory/production based

What is the nature of your major customer base?*

What is the nature of your major customer base?*

	Name of Customer	How many years have they been your customer? (No. of years = No. of months/12)
Customer 1
Customer 2
Customer 3
Customer 4
Customer 5

Please could you list your Top 5 current customer/s and how long they have been your customer*

Please could you provide your financial information for the last 3 years (financial year or calendar year depending on your reporting standards). Please record your answers as whole numbers/percentages and avoid the use of any symbols (“.” or “,”).*

	Year 1	Year 2	Year 3 (latest financial year)
Turnover (ZAR)
Net Profit (%) (calculated as Net Profit/Sales*100)

Optional: Please upload your latest Annual Financial Statement or Statement of Financial Position

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In 5-10 sentences, please tell us what your business offers your customers? (e.g. specific products, categories, services, materials used, and unique value proposition)*
In 5-10 sentences, please tell us what makes you unique compared to your competitors. *
Do you have a tax compliance certificate?*
Optional: Please upload your most recent Tax compliance certificate here:

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What is the nationality of the business owner/s?*
If "other" was selected above and the owner/s is not South African, what is their nationality?
What percentage of Black ownership best describes your firm?*
Which best describes the race of the majority ownership of the firm?*
What percentage of Black ownership best describes your firm?*
What percentage of Black ownership best describes your firm?*
Which best describes the gender of the majority ownership of the firm?*
Which best describes the gender of the majority ownership of the firm?*

MaleFemaleNon-binaryPrefer not to sayOther
What is your B-BBEE level?*
Please upload your B-BBEE certificate or exemption affidavit:*

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Do you have external funding from any of the following sources?*

Self-fundedGrant Funding (E.g. B-BBEE grant, public sector grant)Non-traditional loan financing (E.g. public sector, development finance institute, corporate)Traditional loan financing (E.g. bank)
A series of sector specific questions will now be asked. Please answer those which are appropriate to your business. Sectors are CTFL (Clothing, Textiles, Footwear & Leather), automotive and chemicals.
CTFL: Do you have the capabilities to produce the following products?

Knit tops and dressesWoven tops and dressesSkirtsTailored jacketsPants and shortsRain jackets and outwearHeadwearSwimwearAthleisureDenimsKids/BabywearLeather footwearSynthetic materials footwearOther
CTFL: Do you have any experience working with the following materials?

DenimCottonLinenWoolSilkRayonSpandexNylonPolyesterPoly-FleeceViscoseLeatherOther
CTFL: How many machinists/operators do you employ in your business?
CTFL: Do you have a National Bargaining Council certificate?
CTFL: If applicable, please upload your National Bargaining Council certificate.

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Food & Beverage: What food and/or beverage products do you manufacture?
Autos: What systems do you have capabilities in?

EngineExhaustControlsCoolingGearboxDrive/Prop shaftsSuspensionBrake & SteeringDriver InterfaceInfotainmentOther
Autos: What materials do you have capabilities in?

Mild SteelHigh Strength Low AlloyAdvanced High Strength SteelMagnesiumBoron/MartensiteComposite and PlasticsHigh Strength SteelUltra High Strength SteelAluminium and aluminium alloysCarbon Fibre reinforced Plastics/CompositesCopperGlassBattery minerals (lithium, cobalt, nickel etc)Other
Chemicals: What product/service do you offer your customer/s?
E.g. fabrication services, welding, boiler making, etc.
What major markets do you currently supply into?*

AutomotivesClothing, Textiles, Footwear and LeatherChemicalsFurnitureFood and BeverageRenewable EnergyResins, paints and other coatingsPetroleum and GasConstructionHousehold goodsTransportationMining and MineralsPlasticsPharmaceuticalAgricultureOther
What major markets would you like to supply into in the future?*

AutomotivesClothing, Textiles, Footwear and LeatherChemicalsFurnitureFood and BeverageRenewable EnergyResins, paints and other coatingsPetroleum and GasConstructionHousehold goodsTransportationMining and MineralsPlasticsPharmaceuticalAgricultureOther
What standards and compliance certifications do you have?

National Bargaining Council (e.g. CTFL, furniture)ISO 9001ISO 18001OHSASISO 14001ISO 45001SABSOther
Please upload any standards and compliance certificates here (current or expired):

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Do you measure any of the following performance metrics?

DowntimeAbsenteeismInternal Reject RateOn time deliveryLead TimeNone

What is your average for the following performance metrics?

	Average
Downtime (%)
Absenteeism (%)
Lead time (days)
Internal Reject Rate (%)
On time delivery (%)

Please upload any other supporting documents to help us get to know your business better, such as marketing materials, business plans, photos of your workplace, etc.

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How did you hear about this programme?*
How did you hear about this programme?*

Recommended by a customerRecommended by a colleague or industry peerRecommended by another industry stakeholderFacebook postLinkedIn postEmail advertOnline advertNewspaper advertDurban Chemicals Cluster (DCC)Durban Automotive Cluster (DAC)KZN Clothing and Textiles Cluster (KZNCTC)eThekwini Furniture Cluster (EFC)Cape Clothing and Textiles Cluster (CCTC)Eastern Cape Automotive Industry Forum (ECAIF)Other
Which customer recommended that you apply to this programme? *
Name & Designation
Which colleague or industry peer recommended that you apply to this programme? *
Name & Designation
Which industry stakeholder recommended that you apply to this programme? *
Name & Designation
POPIA Compliance: I agree to the collection, processing and storage of my contact details by B&M Analysts for the purpose of receiving information relevant to the Accelerator programme and industry development. Such information may include industry intelligence invitations, updates on cluster service delivery and offerings, and invitations to industry specific events. Furthermore, I confirm that the collection, processing and storage of personal information by B&M Analysts for the purpose of delivering the Accelerator programme falls within the scope of my company’s policies relating to the protection of personal information, as contemplated in the Protection of Personal Information Act 4 of 2013.*

Yes
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