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AB4IR DIGITAL INNOVATION HUB APPLICATION FORM
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Full Name
*
ID Number
*
Gender
*
Male
Female
Mobile Number
*
Your Email Address
*
Name of Company
*
Company Registration Number
*
Position in Company
*
Majority Shareholding
*
SA Owned
Foreign Owned
Youth Owned
Differently Abled Owned
Woman Owned
Current number of employees
*
Physical Address
*
Website Address
Number of years in operation
*
In which province are you based?
*
Gauteng
Mpumalanga
Limpopo
KwaZulu Natal
Free State
North West
Eastern Cape
Northern Cape
Western Cape
Do you have a Business Plan/Business Model Canvas?
*
Yes
No
What skill set do you/partner have that are relevant to the business?
*
Technology/Product/Service
*
Technology/Product/Service stage of development
*
Idea
Proof of Concept
Prototype
Piloting
Commercial
Expected Support
*
Message
Apply Now!
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