BUSINESS CONNEXION APPLICATION FORM INTERNSHIP PROGRAMME: 2012 PLEASE INDICATE YOUR PREFERRED LOCATION AND AREA OF SPECIALIZATION AS FOLLOWS: *1= FIRST PREFERRENCE, 2 = SECOND PREFERENCE AND 3 = THIRD PREFERNCE
Western Cape (Cape Town) KwaZuluNatal Eastern Cape (East London) Gauteng (Johannesburg, Midrand, Pretoria) Mpumalanga (Nelspruit, Middleburg) Eastern Cape (Port Elizabeth) Limpopo (Polokwane)
PERSONAL DETAILS: Title: Surname: Full Names: Preferred Name: Race:
AFRICAN
Gender
MALE
FEMALE
YES
NO
WHITE
ASIAN
COLOURED
Identity Number: Date of Birth: Disability If Yes, State the nature of disability Driver’s License
YES
Home Language:
CODE
NO
Other Language:
CONTACT DETAILS: Cell phone number: Other Contact number:
Code:
Number:
Email: Physical Address: POSTAL CODE: Postal Address: POSTAL CODE:
Service Management
Bid Administration
Engineering
Administration
ICT Asset Management
Support/Admin Support
Project Management
Networking
Sales
Human Resources
Preferred Location
Business Analyst
Development
NB: ONLY MAKE A SELECTION ON THE UNSHADED BLOCKS