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Incorporated association not for gain
Productivity SA
Private Bag 235
Midrand / (Organization)
International Business Gateway
Cnr New Road and Sixth Road
Midrand / (Address)
Telephone: (011) 848 5300
Telefax: (011) 848 5555 / (Contact details)
Attention: Programme Manager - Turnaround Solutions Technical Support Facility

Dear Sir/Madam

Application to the Turnaround Solutions and Productivity Advisory Council for Turnaround Solutions support and assistance to prevent or minimize retrenchment and job losses in terms of Phase 1 of the Turnaround Solutions Programme

We hereby make application for Turnaround Solutions technical support and assistance. We understand that a preliminary assessment may be undertaken by the Productivity SA or its appointed agent(s) to support this application, and agree to provide information requested by the Productivity SA or its appointed agent(s) to complete such an assessment on the understanding that the information shall be kept strictly confidential.

We understand that Productivity SA will fund 100% of the programme implementation and we agree to be cooperative and committed to the programme. We also agree to oblige by the terms and conditions of the programme.

Should this application be accepted by the Turnaround Solutions and Productivity Advisory Council we also understand that a separate Memorandum of Agreement shall be entered into with the Turnaround Solutions Technical Support Facility before support and assistance may be provided to our proposed Future Forum.

We hereby acknowledge that we will be disqualified from the programme should the terms and conditions of the programme not be adhered to.

Yours faithfully,

Company:Productivity SA:______

Signature:Signature: ______

Signed by:Signed by:______

Date:Date:______

Request for Turnaround Solutions Assistance – Application Form

  1. Name of an organization………………………………………………………………………………..
  1. Physical address…………………………………………………………………………………………

………………………………………………………………………………………………………………….

Province………………………………………………………………………………………………………..

  1. Contact Person…………………………………………………………………………………………….
  1. Position……………………………………………………………………………………………………..
  1. Tel. No:………………………………………….Cell No:………………………………………………..
  1. E-mail Address…………………………………………………………………………………………….
  1. Number of Permanentemployees.…… Temporary employees……Contract workers………… Seasonal workers…………
  1. In which industry sector is your organization?………………………………………………………….
  1. What does your business specialise in?…………………………………………………………………
  1. For how long have you been experiencing a decline?…………………………………………………
  1. Are you contemplating retrenchments?………………………………………………………………….
  1. Is there a union representing employees in the company?…………………………………………….
  1. Name of the union…………………………………………………………………………………………..
  1. Has the company consulted with the union?……………………………………………………………
  1. Number of employees affected…………………………………………………………………………….
  1. Equity Status……..

Black / White / Disabled / Age Groups
M / F / M / M / F / F / 18-35 / 36-55 / 55+
  1. BBBEE Level: ……………………………..
  1. How did you find out about Turnaround Solutions?

……………………………………………………………………………………………………………

  1. Other relevant information and help needed: (What makes you think you need our services?)

……………………………………………………………………………………………………………………..

  1. Does your company contribute UIF? ……………….. UIF or SARS Ref NO? ………………………..
  1. Companies tax no.? (Documentation to be provided. 1. Tax clearance certificate

2. 2 Years audited financials)

Signature …………………………………………………PM/Advisor Signature ……………………………..

Signed By ………………………………………………..Signed By: …………………………………………..

For and behalf of: ……………………………………….On behalf of Productivity SA: ……………………..

Date:………………………………………………………

ProductivitySA-TAS-FRM-00605 Feb 2015Rev 0