PYDA Building C, Bergzicht, Du Toit Street- off Bird Street, Stellenbosch, 7600; PO Box 1102, Stellenbosch 7599 Tel: +27 (0)21 8829273 Fax:0866719976 info@pyda.co.za www.pyda.co.za STUDENT APPLICATION FORM Dear Applicant, PYDA (the Pinotage Youth Development Academy), based in Stellenbosch, develops young, talented South Africans for employment within the wine and fruit industries and related sectors, such as tourism. The Programme The curriculum is custom-designed and combines industry specific technical skills covering the whole value chain, as well as personal development and life skills. The learning will be experiential, with a combination of practical placements and classroom learning. This programme is for 25 students and will run full-time from June 2018 - May 2019. We are calling for applications from talented and committed students who must be: Yes No Are you? 18-25 years of age South African Unemployed or in casual employment Able to demonstrate the commitment to bring about change Able to communicate in English Able to travel to Stellenbosch on a daily basis Able to demonstrate financial need Able to prove you have passed Grade 12 (matric) Historically disadvantaged At the end of their year successful students will: Be work ready Be able to seek permanent employment Be able to create a sustainable economic income Positively influence their families and communities Should you believe you are a good candidate and are able to fully commit to the programme, please complete the attached application form. Contact us Tel: +27 (0) 218829273 or applications@pyda.co.za www.pyda.co.za Applications will close on 03 April 2018 Please email your application form to applications@pyda.co.za or drop it off the PYDA Offices in Stellenbosch. Address: PYDA Building C, Bergzicht Campus, Du Toit Street (Off Bird Street), Stellenbosch, Western Cape Only shortlisted candidates will be interviewed. Should you not receive a response by 30 April 2018 consider your application unsuccessful. PYDA reserves the right not to interview applicants or make an appointment. NPC Registration number: 2012/166864/08 NPO number: 127-086 PBO number: 930042991 BBBEE: Level 4 certified Directors: David Best (Chairman), Chris Ahrends, Jilly Best, Ntsiki Biyela, Peter Cropper, Nikki Munro, Thembalihle Sidaki Patrons: Archbishop Emeritus Desmond Tutu, Jan Boland Coetzee, Dame Linda Dobbs DBE, Thandeka Tutu-Gxashe, Reuben Riffel, Baroness Thomas of Winchester
PYDA APPLICATION Please complete the form in your own handwriting. Attach a copy of your ID, matric certificate. PERSONAL INFORMATION First Name: Second name: Surname: Gender: Male Female Home Language (select one): Afrikaans English Xhosa Other Languages spoken: Other (pls specify): BEE Description: Black Coloured Indian White Other (please specify): ID Number: Date of Birth: Y Y Y Y M M D D APPLICANT S CONTACT DETAILS Cell number: Landline number: Alternate number: PARENT/GUARDIAN S CONTACT DETAILS Cell number: Landline number: Alternate number: Whose number is this? Residential address: Area: Postal code: Do you stay on a farm? Are you related to a farm worker? If yes provide details of the farm. Which high school did you attend? Do you have a criminal record? Do you have any disabilities? If yes, provide details. Page 2 of 5
EDUCATION Other courses you have completed: Name of Institution Name of Course Dates of study 1. 2. 3. 4. 5. EMPLOYMENT 1. 2. 3. 4. 5. Name of Employer Period Employed Your Role Reason For Leaving HOUSEHOLD How many people live in your household? How much money comes into your household in a month? 0 R1000 R1001 R5000 R5001 R10 000 + R10 000 Does any of this income come from Government grants? If yes, indicate which grants: Child support Foster Pension Other How did you hear about this service: Word of Newspaper mouth advertisement Flyer / poster Internet Page 3 of 5
TELL US ABOUT YOURSELF 1. Name the three things you value most in your life 2. What are your three greatest strengths? 3. Which part of your personality or personal habits would you most like to improve? 4. Name 3 people you admire and why 5. Name one person you dislike and why I declare that the information on this form is correct and that I meet the requirements for the course. Y Y Y Y M M D D Signature of Applicant Date Have you attached the following? Page 4 of 5
ID document, Matric certificate and Proof of income Page 5 of 5