Personal Details
Education
Highest level of education
*
None
Grade 12 (NQF 4)
Higher Certificates and Advanced National
(vocational) Cert. (NQF 5)
National Diploma and Advanced certificates
(NQF 6)
Bachelor's degree, Advanced Diplomas, Post
Graduate Certificate and B-Tech (NQF 7)
Honours degree, Post Graduate Diploma and
Professional Qualifications (NQF 8)
Master's degree (NQF 9)
Doctor's degree (NQF 10)
Highest education school name
*
Name of Qualification
*
Second highest level of education
None
Grade 12 (NQF 4)
Higher Certificates and Advanced National
(vocational) Cert. (NQF 5)
National Diploma and Advanced certificates
(NQF 6)
Bachelor's degree, Advanced Diplomas, Post
Graduate Certificate and B-Tech (NQF 7)
Honours degree, Post Graduate Diploma and
Professional Qualifications (NQF 8)
Master's degree (NQF 9)
Doctor's degree (NQF 10)
Second highest education school name
Name of Qualification
Work / Business Experience
Please fill either Business Experience or
Senior Business Management Experience if
applicable.
Business Experience
*
None
0 to 4 years
5 to 10 years
More than 10 years
Senior Business Management Experience
*
None
0 to 4 years
5 to 10 years
More than 10 years
What is your current employment status?
*
None
Unemployed
Self-employed
Currently working planning to resign
Currently working but not planning to resign
Currently working with flexible arrangements
Please select the industries you have had work
experience within
*
Agriculture, Forestry & Fishing
Arts, Entertainment & Recreation
Automotive
Banking
Construction
Consumer Goods
Customer Service
E-commerce
Education
Finance
Food & Beverage
Government
Health Care
Health, Safety, Security & Environment
(HSSE)
Hospitality & Leisure
Human Resources
Information Systems
Insurance
Logistics
Maintenance
Management Consulting
Manufacturing
Marketing
Medical
Mining
Oil & Gas
Others
Real Estate
Rental & Leasing
Retail
Sales
Services
Technology
Telecommunications
Transportation
Utilities
Warehousing
Wholesale
Write down the number of team members you
currently manage
*
What attracted you to Shell and the
self-employed retail opportunity?
How will you deliver the needs and aspirations
of Shell's customers?
What other self-employed opportunities are you
currently operating, and/or, are considering?
Service Station Preferences
* Same location cannot
be selected . Select other location .
Financial Information
Credit Information
Have you ever been declared insolvent?*
No
Yes
Please specify *
Filled only when you select Yes
Have you ever had a judgement against you or
have a judgement that is pending?*
No
Yes
Please specify *
Filled only when you select Yes
Have you been a member of a Company or a
Close Corporation that has been declared
insolvent?*
No
Yes
Please specify *
Filled only when you select Yes
Are you currently involved in any legal
disputes?*
No
Yes
Please specify *
Filled only when you select Yes
Will any other person or juristic person have
an interest in the business?*
No
Yes
Please specify *
Filled only when you select Yes
Employment References
CV Upload
Declaration by Applicant
Important note:
incomplete and duplicate submissions will
result in an automatic decline of the
application.
This application form or acceptance of the
Applicant to the next stage of the application
process does not constitute an offer of a
Service Station or a commitment to offer one.
Shell’s decision regarding this application by
the Applicant is final and is not subject to
appeal or arbitration.
Shell reserves the right to withdraw this
application at any stage of the process as and
when it deems appropriate to do so.
The franchise application process has various
stages, the acceptance of the application and
approval to proceed to the next selection
stage does not constitute an appointment as a
Shell Franchisee. In instances where the
Applicant has been appointed as a Shell
Retailer, Shell will formally communicate such
an appointment.
Liability – To the fullest extent permitted by
law, neither Shell nor their partners or
agents shall be responsible for any loss,
damage or injury whatsoever suffered by the
Applicant (including but not limited to any
direct, indirect, consequential, special,
punitive or incidental loss or damages) or for
any personal injury (whether physical or
mental) suffered or sustained by the Applicant
as a result of or in connection with the
application process. Shell will not be held
legally liable for any personal losses what so
ever that the Applicant may incur in the
process of applying for a Shell Service
Franchise or rejection of their application at
any stage of the selection process including
after training.
Transformation – Shell has aspirations on
transformation that seek to align its Retailer
Profile to the Nationally Economically Active
Population (NEAP) statistics. To achieve this,
Shell will take steps and select prospective
franchisees in line with its assessed gaps of
its current Retailer profile and its programme
to align it to the NEAP.
Costs –In the event that the Applicant makes
it to the next stage of the application
process, there will be costs payable by the
Applicant. These costs include, but are not
limited to, training in the event that the
Applicant makes it to the final phase of the
process. The above-mentioned costs are not
refundable under any circumstances.
Assessments – Shell will do a number of
assessments as part of the application process
some of them will require payment by the
Applicant. The successful completion of any of
the assessment stages does not imply that the
Applicant is entitled to a Shell Service
station.
CREDIT CHECKS
It is a Shell requirement that Credit Checks
be done on the Applicant and by signature at
the bottom of this form Shell is hereby
authorised to do the checks.
The Applicant hereby authorises Shell to make
enquiries and to use, exchange and disclose to
any credit provider or Credit Bureaus, any or
all information that it may obtain in the
course of doing the credit checks.
It is the Applicant’s responsibility to
maintain a healthy credit profile. Shell
reserves the right to do credit checks on an
on-going basis during the course of the
application process.
In addition to Credit checks, the Applicant
will be required to provide information
related to proof of their Assets and
Liabilities.
PERSONAL BACKGROUND CHECKS
Shell will as part of this application process
conduct back ground checks on the Applicant
that includes but not limited to criminal
records, academic qualifications verification,
Identity Document (ID) authentication,
restrictions and listing on sanctions lists.
To effect the checks, Shell will utilise
various sources of information at its disposal
and reserves the right to re-do the checks at
various stages of the application process as
part of on-going risk management based on the
outcomes of the checks, it will review any
decision that it may have taken about the
Applicant and their candidature.
ANTI-BRIBERY AND CORRUPTION (ABC)
DECLARATIONS
The Shell Anti-Bribery and Corruption (ABC)
policy requires that prospective Franchisees
declare their Political Office
responsibilities. The said responsibilities in
terms of the ABC policy are outlined in the
ABC Declaration section in this application
form.
Shell is apolitical and in its business
dealings. The ABC declarations enable Shell to
manage and separate the political
responsibilities of the Applicant from its
business dealings with the Applicant.
Should the Applicant be successful, they are
required at all times to maintain their ABC
standing and when there is a change in their
lives and take on a political office
responsibility, such a change must be duly
declared and prior authorisation by Shell
obtained before it is accepted.
Shell reserves the right to withdraw or cancel
any appointment at any stage of the
application process on the basis of ABC
information that may not be compatible with
its policies or where new undeclared
information arises during the process or after
appointment as a franchisee.
TAX COMPLIANCE
The Applicant is required to comply with the
relevant tax laws as part of the application
process and on an on-going basis.
Shell requires that the Applicant furnishes
Shell as part of this application process a
valid Tax Clearance from the South African
Receiver of Revenue (SARS).
Failure to provide a valid Tax Clearance
certificate at any stage of the process will
result in the withdrawal of the Applicant from
the process. Shell will not refund nor be held
liable for any costs that may have up to that
stage been incurred by the Applicant.
INFORMATION HANDLING
Shell acknowledges that it will receive
personal information relating to the
Applicant.
The information in the possession of Shell
will be handled in line with relevant
legislation regarding the handling and
protection of personal information. In
addition to the legislated requirements, Shell
has its own policies regarding safe guarding
of such information. For more details on how
Shell handles your information visit the Shell
Privacy Policy on
Privacy notices | Shell South Africa
Shell is duty bound by various legislation to
report or pass on information to the relevant
authorities where it encounters non-compliance
with the laws of the Republic. In the event
that Shell encounters such non-compliance or
adverse information during this process, it
will hand over such information to the
relevant authorities.
The Applicant through their signature at the
bottom of the application form hereby consents
to Shell passing such information to the
authorities as and when it picks it up.