gold grads sign up form
First name as written on ID *
Your answer
Surname as written on ID *
Your answer
Any other names that you are known by
Your answer
ID number *
Your answer
Nationality *
Cell number *
Your answer
Cell number of an alternate contact person
Your answer
Email address - if you don't have one, you can ask a gold team member to create one for you! *
Your answer
Country currently living in *
Region or province living in
Date of birth *
MM
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DD
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YYYY
Gender *
BEE status (for those in South Africa)
Name the school or site where you did the gold programme *
Are you, or were you, a Peer Educator, a Facilitator Intern or both? *
What year did you finish school? *
Your answer
Highest qualification achieved *
If you don't have any post school qualifications, do you want to study after leaving school?
If you have got a certificate, diploma or degree since leaving school, what is your qualification in? (choose the closest option)
What best describes your current situation?
If you are currently studying, what are you studying? (choose the closest option)
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?
Are you looking for work? *
What kind of work would you like to do? (choose the closest option)
Are you open to other job opportunities that are not in your main area of interest?
If working, what line of work are you in? (choose the closest option)
Name of the company you work for
Your answer
Start date of job
MM
/
DD
/
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?
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