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Supplier Registration Form BOTA. DHRA. CSD. P02. F01 Issue No. 03 Print and complete in block letters Please submit certified copies where required together with the return of this questionnaire to Botswana Training Authority Private Bag BO 340 Gaborone ATT Purchasing Officer Department of Human Resource and Administration Please note that BOTA reserve the right to approve suppliers at its sole discretion and prerogative. 1. COMPANY DETAILS Registered Name of Business Trading Name of Business Company Registration no. Country of registration Trading license no. Business type Partnership sole proprietor incorporated Co. or other please specify VAT Registration no. if applicable Tax Clearance Certificate no. Description of Core Business 2. ADDRESS AND CONTACT INFORMATION Physical Address include Plot No* suburb city Full Postal Address Telephone Number Fax Number Website Company E-Mail Contact Person His/Her position 03/01-07-2010 Page 1 of 3 3. BANKING DETAILS Bank Name Account Number Branch Name Branch Code Type of Account Country where account is held 4. OWNERSHIP DETAILS NAME AND SURNAME CITIZENSHIP SHAREHOLDING Please attach proof 5. REFERENCES Please provide details of three referees we may contact to seek reference in relation to services rendered by tour business. Business Name Address Goods/services 6. MANAGEMENT SYSTEMS Have you implanted any management system Tick in the appropriate box Yes No If yes give details below Reference standard e*g* ISO 9001 2008 OHSAS 18001 Certified If certified give name of certifying body otherwise write N/A Please submit any other information that you deem relevant for BOTA to know I the undersigned duly authorized by our company certify that I understand the content of this document have taken note of the attachments and declare that the information supplied is correct and complete and that we will keep you informed should any of this information change in future. TO BE COMPLETED AND SIGNED BY AN AUTHORISED COMPANY REPRESENTATIVE Name Designation Signature Date. 1. COMPANY DETAILS Registered Name of Business Trading Name of Business Company Registration no. Country of registration Trading license no. Business type Partnership sole proprietor incorporated Co. or other please specify VAT Registration no. Business type Partnership sole proprietor incorporated Co. or other please specify VAT Registration no. if applicable Tax Clearance Certificate no. Description of Core Business 2. ADDRESS AND CONTACT INFORMATION Physical Address include Plot No* suburb city Full Postal Address Telephone Number Fax Number Website Company E-Mail Contact Person His/Her position 03/01-07-2010 Page 1 of 3 3. if applicable Tax Clearance Certificate no. Description of Core Business 2. ADDRESS AND CONTACT INFORMATION Physical Address include Plot No* suburb city Full Postal Address Telephone Number Fax Number Website Company E-Mail Contact Person His/Her position 03/01-07-2010 Page 1 of 3 3. BANKING DETAILS Bank Name Account Number Branch Name Branch Code Type of Account Country where account is held 4.

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