gold grads sign up form

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First name as written on ID *

Surname as written on ID *

Any other names that you are known by

ID number *

Nationality *

South Africa

Zambia

Botswana

Cell number *

Cell number of an alternate contact person

Email address - if you don't have one, you can ask a gold team member to create one for you! *

Country currently living in *

South Africa

Zambia

Botswana

Region or province living in

Eastern Cape

Free State

Gauteng

KwaZulu Natal

Limpopo

Mpumalanga

Northern Cape

North West

Western Cape

Copperbelt (Zambia)

Central Zambia

Clear selection

Date of birth *

YYYY

Gender *

Male

Female

BEE status (for those in South Africa)

Black

Coloured

Asian

Indian

White

Clear selection

Name the school or site where you did the gold programme *

Bloekombos

Chikola

Chingola

Hector Peterson

Imizamo Yethu

Inkunzi

Khanyisani

Klein Nederburg

KwaPata

Lungisani

Masibambane

Mbambiso

Mmadikana

Noorder Paarl

Parkdene

Paulus Jobert

Piet Potgieter

Sekela

Skhwahlane

Siqongweni

Soshangane

Thembalethu

Tji-tjila

Zamazulu

Other:

Are you, or were you, a Peer Educator, a Facilitator Intern or both? *

Peer Educator

Facilitator Intern

Both Peer Educator and Facilitator Intern

What year did you finish school? *

Highest qualification achieved *

Have not yet passed grade 12

Grade 12

Post school certificate

Post school diploma

University degree

If you don't have any post school qualifications, do you want to study after leaving school?

Yes

Clear selection

If you have got a certificate, diploma or degree since leaving school, what is your qualification in? (choose the closest option)

Legal, Finance and Personal/Office Administration

Marketing and Sales (including PR, Events and Media)

Human Resources, Education and Social Development/CSR

Information Technology and Engineering (including Project Management, Architecture, Construction)

Operations and Manufacturing

Hospitality, Travel and Tourism (including Customer Services)

Healthcare, Sport and Recreation

Clear selection

What best describes your current situation?

Studying

Working

Studying and working

Neither studying nor working

Clear selection

If you are currently studying, what are you studying? (choose the closest option)

Legal, Finance and Personal/Office Administration

Marketing and Sales (including PR, Events and Media)

Human Resources, Education and Social Development/CSR

Information Technology and Engineering (including Project Management, Architecture, Construction)

Operations and Manufacturing

Hospitality, Travel and Tourism (including Customer Services)

Healthcare, Sport and Recreation

Clear selection

If you are studying, were you made aware of this study opportunity through a gold contact/ the gold network or did your time in the gold programme increase your ability to find this opportunity yourself and support your ability to apply by yourself?

Yes

Clear selection

Are you looking for work? *

Yes

What kind of work would you like to do? (choose the closest option)

Legal, Finance and Personal/Office Administration

Marketing and Sales (including PR, Events and Media)

Human Resources, Education and Social Development/CSR

Information Technology and Engineering (including Project Management, Architecture, Construction)

Operations and Manufacturing

Hospitality, Travel and Tourism (including Customer Services)

Healthcare, Sport and Recreation

Are you open to other job opportunities that are not in your main area of interest?

Yes

Maybe

Clear selection

If working, what line of work are you in? (choose the closest option)

Legal, Finance and Personal/Office Administration

Marketing and Sales (including PR, Events and Media)

Human Resources, Education and Social Development/CSR

Information Technology and Engineering (including Project Management, Architecture, Construction)

Operations and Manufacturing

Hospitality, Travel and Tourism (including Customer Services)

Healthcare, Sport and Recreation

Clear selection

Name of the company you work for

Start date of job

YYYY

Did you find your job through a referral from gold? If not, did your time in the gold programme increase your ability to research, apply for and conduct yourself well in the interview?

Yes

Clear selection

Submit

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