Company SDL Number

Company Registered Name

Company Trading Name

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COMPANY DETAILS

ANNEXURE A

Details of Contact Person Name: E-mail:

Tel: Cell:

SLO/SDF/Training Provider Contact Details

Name: E-mail:

Tel: Cell:

Number of Learners Skills Development Intervention (tick relevant box) Grant Amount Applied for

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Skills Programmes Single Unit Standards Non-Credit Bearing R

W&RSETA Regional Office

Eastern Cape

Free State

Gauteng North

Gauteng South

KwaZulu Natal

Limpopo Mpumalanga Northern Cape

North West

Western Cape

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W&RSETA StampCompany Stamp (if applicable)