USB Small Business Academy Development Programme. Application for Admission to Study Class of 2019

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USB Small Business Academy Development Programme Application for Admission to Study Class of 2019 The University of Stellenbosch Business School s Small Business Academy (SBA) Development Programme is a postmatric programme that offers full-time small business owners in the Western Cape the opportunity to gain business knowledge that will enable them to grow and expand their existing businesses. The SBA Development Programme is presented on a part-time basis in block weeks. This is a post-matric level programme. A certificate from Stellenbosch University is awarded to successful participants. The programme consists of: 12 hours of mentoring 4 practical workshops 5 weeks of on-campus training at the University of Stellenbosch Business School, Belpark Campus, Bellville, including assignments 1 business plan presentation to the SBA s Academic and specialist Panel. The SBA Development Programme is selection-based, following ability testing and an interview with the Selection Committee. Only selected participants will be notified before commencement of the programme. Programme fee: Application deadline: 25 January 2019 Programme starts: 11 March 2019 R2 400 (R50 application fee non-refundable, R900 registration fee upon selection, and R500 payable in May 2019, R500 payable in July 2019, R500 payable in September 2019) Entry requirements* Age: 23 years or older Full-time owner of an established small business of at least two years (24 months) or older (thus, applicant must not be in the employment of another company while running current business) Applicants must live or work in townships or low-income areas of the Western Cape Matric/Grade 12 (this is looked at on a case-by-case basis if applicants have not completed Matric/Grade 12) No previous management education at tertiary level is required. Must be proficient in English Students cannot be registered to study part-time at another institution during course of the 2019 USB SBA Development Programme

Students must present a business plan on the company/business that they indicated on their application forms. Please complete the following application form and submit this together with the relevant documentation (see checklist at the end of this form). Please note that this application form is one of the most important documents used by the Academy to evaluate your suitability for the programme. Complete it carefully and ensure that you fill out every line. * Please note that final selection is at the discretion of the SBA Selection Committee. APPLICANT DETAILS Surname Name (s) Nickname (name you want to be called during the programme): Date of birth Age Home (street, suburb) address and postal code Male Female South African ID number If non-south African: Passport and work permit numbers Home phone Cell E-mail address COMMUNICATION CONNECTIONS Tick appropriate answer. Do you: Own a smartphone with access to e-mail or WhatsApp? Yes No If no, do you have your own cell phone or use someone else s? My own Someone else s Own a PC, laptop or tablet? Yes No

Have access to the internet from home or your business? Yes No If no, how do you access the internet? Internet café Library Other: Know how to attach a document to an e-mail? Know how to create a document in Microsoft Word? Know how to create a document in Microsoft Excel? Know how to create a slideshow in MS PowerPoint? No Yes: Well Intermediate Poorly No Yes: Well Intermediate Poorly No Yes: Well Intermediate Poorly No Yes: Well Intermediate Poorly Language Home language: isixhosa Zulu English Afrikaans Other: English literacy level: Read Well Intermediate Poorly Write Well Intermediate Poorly Speak Well Intermediate Poorly HIGH SCHOOL DETAILS School name Year you matriculated If you did not complete matric, what is the highest grade you have passed? TERTIARY EDUCATION Have you studied after matric? Yes No If yes, please give name of the programme, how many years you completed or year of graduation BUSINESS STATUS Name of business: Your job title: Owner Co-owner Director Manager Other: Services or products: Industry: Number of years the business has been running full-time: Is the business registered? Yes No If yes, registration number:

Number of employees (excluding owner): Number of regular clients/months: Monthly income of your business: 0 R2 500 R2 500 R7 500 R7 500 R15 000 R15 000 R30 000 +R30 000 Monthly expenses of your business: 0 R2 500 R2 500 R7 500 R7 500 R15 000 R15 000 R30 000 +R30 000 Business street address, including postal code: Business postal address, if applicable: Business landline number: Business cell phone number: Business e-mail address: Business website address (if applicable):

BUSINESS REFERENCES Include the names of two people that we can contact as references for you. They can be from any of your clients or suppliers. References should not be older than 3 years. 1. Surname Name Organisation name Role at organisation E-mail Contact number (work or cell) 2. Surname Name Organisation name Role at organisation E-mail Contact number (work or cell) STATEMENT OF INTEGRITY I hereby certify that I have provided accurate information in this application. I understand and agree that any misrepresentation or omission of facts in my application will justify the denial of admission, the cancellation of admission, or expulsion. This is my own, honest statement to the SBA Admissions Committee. I hereby confirm that I have read and understood Annexure A. I hereby commit myself to following the guidelines and stipulations of the USB Small Business Academy Development Programme 2016 if I get selected to participate in the programme and I furthermore commit myself to making the course fee payments as laid out in Annexure A or risk expulsion. Name and Surname: Signature: Date: CHECKLIST A certified copy of the first page of your South African identity document (ID book) or passport (if you are a foreign national, please include a copy of your work permit) A completed and signed application form and the four essays on separate sheets Certified copies of your academic certificates and/or Senior Certificate Proof of payment of R50 non-refundable application fee Please submit your application form with all the attachments by Friday 25 January 2019. Applications can be submitted in any of the following ways:

By post: The application form with proof of payment can be posted in a sealed envelope addressed to: USB Small Business Academy, PO Box 610, Bellville, 7535. Delivery by hand: The application form with proof of payment can also be dropped off at USB Belpark Campus Carl Cronje Drive Bellville 7535 For attention: Benji Matshoba By e-mail: Scan the application form and proof of payment and send to usbsba@usb.ac.za For more information, call Benji Matshoba 021 918 4937. Proudly supported by: