NEW CLIENTS We so glad to have you on board. Please fill in the form below so we can capture your details and get started. Any questions, please shout. HiddenNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.South African CompanyInformation required from the person acting for the companyRegistered name of company:(Required) Registration number:(Required) Registered address:(Required) Vat Number: Name under which the company conducts business:(Required) Address from which the company operates or, if the company operates from multiple addresses:(Required) The address of the head office of the company:(Required) Details of company manager (the principal executive officer)Your Name(Required) First Last Date of Birth(Required) MM slash DD slash YYYY Contact Number:(Required)Nationality if not a South African citizen: Residential address:(Required) Street Address Address Line 2 City ZIP Code Your Email Address(Required) Email Address Confirm Email Address The identity document of each manager of the company or a similar document bearing a photograph of the manager concerned and his/her full name, date of birth ,and identity number(Required) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB. Please uploadConsent(Required) I have read and agree to the Terms and ConditionsThese can be found in the footer or at https://clickscount.co.za/terms-and-conditions/ Δ South African citizens/ residentsYour Name(Required) First Last Date of Birth(Required) MM slash DD slash YYYY Identity Number:(Required) Residential address:(Required) Street Address Address Line 2 City Postal Code Phone(Required)Your Email Address(Required) Email Address Confirm Email Address The identity document or a similar document bearing a photograph of the person concerned and his/her full names, date of birth and identity number(Required) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB. Please uploadConsent(Required) I have read and agree to the Terms and onditionsThese can be found in the footer or at https://clickscount.co.za/terms-and-conditions/ Δ
