GOLD Grad Sign Up Form
First name *
Your answer
Surname *
Your answer
ID Number *
Your answer
Nationality *
Cell number
Your answer
Home number
Your answer
Email address
Your answer
Are you on Facebook?
How should we contact you?
Country
If you are South African select one of the provinces below.
If you are from Zambia select one of the following regions.
Date of birth *
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Gender *
BEE Status
Do you have a valid driver's licence?
Cell number of alternate contact person
Your answer
Highest grade achieved *
Year you achieved your highest grade *
When is/was your last year at school? *
Do you want to study after leaving school? *
What do you want to study after school (choose closest option)?
Are you currently studying at a tertiary institution?
If yes, what are you studying?
Were you made aware of this study opportunity through the Gold Grads site?
What tertiary qualification do you have?
Your answer
What is your qualification in? (Choose closest option)
Are you a Peer Educator or a Facilitator?
Do you have a GOLD CV? *
Do you have a Testimonial? *
Have you done a Groper? *
If yes, what is your Groper type?
Name the IO that delivered the GOLD program. *
Name the school or site where you did the GOLD program. *
Your start date *
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Your end date *
MM
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List organisations/clubs that you belong to.
What position in your club/organisation do/did you hold?
If you have held any leadership positions then please list them.
Do you have experience with email? *
Do you have experience with the Internet? *
Do you have experience with MS Word? *
Do you have experience with MS Excel? *
Do you have experience with MS Powerpoint? *
Do you have experience with MS Access? *
Since leaving school, have you participated in a community upliftment activity?
Since leaving school, have you volunteered or participated in a community activity in your implementing organisation?
If yes then please list the type of projects your have participated in.
Are you looking for work? *
What kind of work would you like to do? (Choose closest option)
Are you currently employed? *
What line of work are you in? (Choose closest option)
Name of company you work for.
Your answer
Start date of job.
MM
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DD
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YYYY
Did you find your job through a referral from GOLD?
ALL ABOUT YOU
What are your greatest strengths?
Your answer
What was your greatest learning as a GOLD Peer Educator or Facilitator?
Your answer
Using no more than 150 words write a brief description of yourself including your interests, things you are good at, plans for your immediate future, ideal job, study plans and travel ideas.
Your answer
FOOD INDUSTRY
Have you ever heard of the food production industry? *
Do you know what job opportunities are available in the food production industry? *
Would you like to work in the food production industry? *
Do you think the jobs in the food production industry are interesting? *
What kind of jobs do you think food production includes? Tick from the list of jobs (*you can select more than one answer) *
Required
Would you consider farming as a future career? *
Do you think the jobs in the food production industry are interesting? *
Which of the following study courses are relevant to the food production industry? (*you can select more than one answer) *
Required
Select which jobs you would like to work in (*you can select more than one answer) *
Required
Your answer
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