4IR RSA Forum Business Directory Registration Form
Please take note that this information will be published on a public 4IR RSA website. You may omit any information you do not wish to have publicly published.
Email address *
Type of registration: *
Organization\Individual details
Users will be able to search for skills, services, products, location of business etc. based on this information.
Organization\Individual name: *
Provide a synopsis about your business or yourself(approx. 500 words or less, cut & paste accepted): *
List keywords for your services, skills, experience and offerings (separated by a comma) Example: Robotics, Augmented reality, AI, etc.) *
Upload a short company profile (not compulsory):
Upload a company logo (PDF or image files):
Nature of business (multiple selections accepted): *
Industry sectors (multiple selections accepted): *
Business Geographic Coverage (multiple selections accepted):
Contact information
Users will be able to contact the business by means of the below information.
Physical address:
Contact person name and designation: *
Contact email:
Secondary contact email:
Phone number:
Mobile number:
Media links (Website, Linked-in, Facebook etc.):
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