COMPANY INFORMATION: / RegistrationNo
Company Name
Trading Name
/Company Registration No
Fin Year End / VAT Registration NoPostal Address
/Physical Address
Code: / Code:Website Address / Website link to appear on website
Contact Person
(as it will appear on the website) / Name:
Email: / Tel:
Capacity: / Fax: / Cell:
CONTRACTOR / TRAINER/INSTRUCTOR INFORMATION:
Name(s) / ID Number / Cell Number / Email Address(es)
PLEASE SUBMIT YOUR REGISTRATION APPLICATION WITH THE FOLLOWING:
- Required fees as per Fee Structure
- Example of certificate so we can do the template
- Brief CV of the Driving School and the Driving Instructors
- Current training material and process-outlay for evaluation.
IMPORTANT NOTICE:
Please send all required documentation and this application form to Project Manager – Tim Colvin
Tel: 011 656-2201 or 011-082 785 9277 Fax: 086 5008 123 or Email:
Please note that once all the information is received an appointment will be made to do relevant evaluation(s)and an invoice will be sent for payments received. A debit order is required should you need to pay monthly fees.
The following documentation is available on the Shayela Approved website Debit order instruction, Confidentiality agreement, Fee structures, Terms and Conditions and Code of Conduct.
Defensive Driving Project Pricing / Fees Schedule 2006
Item description
/ Amount / Vat / Inclusive Vat / Terms of payment
Affiliation Fee per company per annum / R 2,500.00 / R 350.00 / R 2,850.00 / On Application and anniversary
Affiliation Fee per instructor per annum / R 1,200.00 / R 168.00 / R 1,368.00 / Up front upon application *prorata
Annual fee per instructor / R 600.00 / R 84.00 / R 684.00 / Yearly on anniversary
Certification fees per certificate number / R 50.00 / R 7.00 / R 57.00 / Cumulative paid per month
DECLARATION AND ACCEPTANCE:
I______in my capacity as______within (company name) ______hereby confirm that I have the authority to make this application and to sign these documents on behalf of (company name)______and the Directors of this company.
I declare that all the information contained in this document is true and accurate and that I have read and hereby accept the Terms and Conditions and Code of Conduct of Shayela Approved (Pty) Ltd. I understand that on registration of the company will become liable to pay fees in lieu ofaffiliation as per this application and fee structure. Shayela Approved reserves the right to do all required checks with TransUnion ITC.
Signed at______on the______day of______20__.
______
Signature Designation
BANKING DETAILS:
Account Name: Shayela Approved (Pty) Ltd
VAT Registration No: 4080231386
Bank: Standard Bank
Branch: Midrand
Branch Code: 1155
Account No:411 387 588
OFFICE USE ONLY
Application complete / Payment Method / EFT Cash Cheque / Invoice Requested
Proof of Payment / Approved Date / Amount Paid
Basil Mann
082 557 1750
011 314 4562
P.O.Box 1511
Halfway House
1685