Company’s Legal Name

Company’s Operating Name

Street Address

Country

City

Province/State

Postal Code

Website

Is this your corporate head office?

Yes

No

First Name

Surname

Business Title

Email Address

Telephone Number International number format required e.g. +27 21 761 0000

Cellphone Number International number format required e.g. +27 82 812 1234

Give a short description of the product(s) and/or service(s) you provide.

Please select the industries / fields below that apply to your company.

Marketing Marketing services, advertising, sales and business promotions etc.

Office Equipment & Accessories Supplies, printing and multi-function devices, subscriptions, etc

Financial Services Banks, financial advisors, investments, etc

Rewards Loyalty, promotional products, etc

Financial Services Banks, financial advisors, investments, etc.

IT & Telecommunications Hardware, software, telecommunications, maintenance, IT professionals, business services etc

Operations Hardware, software, telecommunications, maintenance, IT professionals, business services etc

Financial Management & Services Real estate, building maintenance, construction, furniture, utilities etc.

Professional Services Non-IT, auditing, accounting, consulting, legal services etc.

Travel Corporate, meetings, conferences, etc

Human Resources Benefits, incentives, rewards, relocation, training, education, etc

Are you registered with MasterCard/Visa?

Yes

No

Which of the following apply to your company? Choose all that apply.

EME (turnover <R10 million)

QSE (turnover >R10 million; <50 million)

Generic (turnover >R50 million)

BBBEE certified:

Level

Non-compliant

Level

> 51% black ownership

> 51% black female ownership

Financial Year End

Latest audited financial statements results

Yes, I have read and agree with Capitec's Supplier Code of Conduct

Business Services

supplier registration

Company info

Company contact info

Primary contact info

Supplier Overview

Responsible business practices

Financial info

Supplier code of conduct

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