(Please indicate whether your business is formalised or not. "Formalised" refers to a registered enterprise while "Non-formalised" refers to a non-registered enterprise.)

Registered Name of Enterprise (If Applicable) *

Location of Operation *

City of Johannesburg
City of Tshwane
West Rand

(Targeted municipal areas above, applicants are encouraged to indicate their primary area of operation, ward number and location/township)

Ward Number

Location/Township

Enterprise / Operation Focus

Cleaning Products (Industrial Segment)
Household Products (Detergents & Related)

(Applicable to enterprises or operations involved in chemicalmanufacturing. Please select the relevant segment(s) you may select both if applicable.)

Ownership Structure

Youth
Women
Persons with Disabilities
Historically Disadvantaged Individual

Access to Safe and Functional Workspace *

Yes
No

Willingness to Participate in Training and Enterprise Development *

Yes
No

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