SOLDROCK MOVE TRADE AND PROJECTS

Initials and Surname

Physical Address

Postal Address

ID number

Contacts Details: cell/ telephone

Email Address

RACE

BLACK
WHITE
COLOURED
ASIAN

Home Language

Isizulu
Sisotho
English
Xhosa
Swati
others

Gender

Female
Male

Disability

YES
NO

The aims you have for the business

Tell us about yourself

What catagorie do you fall

Student
Working
Retired
Others

HOW MUCH SHARES YOU WANT TO BUY

50% = R10 000
45% = R9 000
40% =R8 000
35% = R7 000
30% = R6 000
25% = R5 000
20% = R4 000
15% = R3 000
10% = R2 000
5% = R1 000
others

Bank of your choice

FNB
ABSA
NEDBANK
STANDARD BANK
OTHER

BANK ACCOUNT

SAVINGS
CHEQUES
DEBIT
OTHER

What interested you about Us

Do you have shares some where else

YES
NO

IF YES MANTION