Instructions on how to fill the registration questionnaire plus definitions which are applicable
- Use cross X or the right tick √ or Yes/No where applicable.
- Your writing must be eligible or clear to be read.
- Qualification status applies to any degree irrespective of which institution it was obtained from.
- Qualification status applies to any diploma irrespective of which institution it was obtained from.
- Qualification status applies to any certificate irrespective of which institution it was obtained from.
- If you have not competed any degree or diploma or certificate, please indicate which level you have completed.
ü For example First Semester or S1 towards a degree
ü For example N1, towards N6 or national certificate
ü List any other level that applies to your level of qualification
Note: If you have only completed levels and not complete course specify in the box next to your certificate, diploma or degree
1. Generic Information Details
First Name | |
| Surname | |
| Telephone Number | |
| Cell Number | |
| Email Address | |
| Male | |
| Female | |
| Race | |
| African | |
| Indian | |
| Coloured | |
| Age Range: | |
| 15-25 | |
| 25-35 | |
| 35-45 | |
| 45-55 | |
| 55-65 | |
| 65-75 |
2. Present Geographical Location
Town | |
| Province |
3. Qualification Details
3.1 Do you possess any of the qualifications mentioned below? Please tick where appropriate and specify qualification speciality beside your degree area.
Course Name | Certificate | Diploma | Degree |
| Example 1 | N1 or N2 | S1 | completed |
| Example 2 | completed | 2-year | 1-year |
| Actuarial Science | |||
| Agricultural Science | |||
| Animal Science | |||
| Architecture | |||
| Aviation Science | |||
| Biotechnology | |||
| Building Science | |||
| Chemical Engineering | |||
| Chemistry | |||
| Civil Engineering | |||
| Computer Systems Engineering | |||
| Crop science | |||
| Dental Therapy | |||
| Dentistry | |||
| Electrical Engineering | |||
| Electronics Engineering | |||
| End User Computing | |||
| Environmental Science | |||
| Fire Technology | |||
| Fitting and Turning | |||
| Food technology | |||
| Geology | |||
| Horticulture | |||
| ICT - please specify graphic designer, etc | |||
| Land Surveying | |||
| Marine Science | |||
| Mathematics | |||
| Mechanical Engineering | |||
| Medicine | |||
| Metallurgy | |||
| Meteorology | |||
| Nursing Science | |||
| Optometry | |||
| Pharmacy | |||
| Polymer Technology | |||
| Quantity Surveying | |||
| Software Development | |||
| Statistics | |||
| Water Technology | |||
| Web and Multimedia | |||
| Welding Science | |||
| Building Science | |||
| Other ( specify) |
Questions | Answers |
| 1. Are you working? | |
| 2. Where are you working? | |
| 3. How many years of experience in current current job? | |
| 4. Which industry are you working in? | |
| 5. Is your job activities related to your qualification? | |
| 6. Are you working in research? | |
| 7. Which field of research? | |
| 8. Would you change your job for another in another industry | |
| 9. Which field would you change to? | |
| 10. Why would you change to a new field? | |
| 11. Do you have work experience or volunteer experience in other fields? | |
| 12. Please state all of question seven (7) above. | |
| 13. Would you recommend someone to study in your field? | |
| 14. Give reasons why: |
4. Business and Entrepreneurial Interest
1. Have you started or considering starting a Science, Engineering and Technology related Business? | |
| 2. What kind of SET Business? (Biotechnology, etc) | |
| 3. In your opinion, is it hard to get funding for starting the above business? | |
| 4. Do you have experience to run the business? | |
| 5. What kind of experience would you want to acquire in order to succeed? | |
| 6. Have you invented or patented any SET idea in the last 20 years? | |
| 7. Please name the invention and year of invention. | |
| 8. Do you know any South African black who invented or patented Have you invented or patented and idea in the last 20 years? | |
| 9. Name the person and give contacts if available. |
6. Associations
List associations you have joined: |
7. Salary Scales
Note: Please tick or cross with an X
R 5,000 – R10,000 | |
| R 10,000 – R15,000 | |
| R 15,000 – R20,000 | |
| R 20,000 – R25,000 | |
| R 25,000 – R30,000 | |
| R 30,000 – R35,000 | |
| R 35,000 – R40,000 | |
| R 40,000 – R50000 | |
| R 50,000 and Above |
8. Please attach your CV when returning the questionnaire.
