APPLICATION FORM

EXPORT MARKETING AND INVESTMENT ASSISTANCE

National Pavilions & Local Pavilions Export Councils, Joint Action Groups and Industry Association
All correspondence to EMIA should be sent to one of the following addresses:

PHYSICAL ADDRESS (Hand/Courier Deleiveries)

Mapungubwe - the dti Group House EMIA: Division Building A: Ground Floor 77 Meintjies Street Sunnyside Pretoria 0002

POSTAL ADDRESS (Registered Mail)

EMIA Division Building A, Ground Floor Private Bag X84 Pretoria 0001

Correspondence that has not been properly addressed to the dti can be incorrectly forwarded to other departments. the dti does not accept responsibility for mail that has not been properly addressed

Effective 1 April 2011

Warning: Under no circumstances should any application form and/or the claim form be altered. Amended application/claim forms will not be considered for evaluation.

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EXPORT MARKETING AND INVESTMENT ASSISTANCE Application form for Export Councils, Joint Action Groups and Industry Associations
Important Notice to EMIA Customers Customers please note that this application form goes hand-in-hand with the Guidelines booklet. The conclusion of a successful application is only possible if it is done with cross-reference to the requirements as laid out in the Guidelines booklet. Section A - Particulars of Applicant
Name of Councils, JAG or Association Trade Name Entity type (Please Cross X Applicable) Entity registration number Name of the show Show dates Location: City Name under which you will exhibit How many times have you participated in this Pavilion previously? Have you already appointed an agent in the country where this National Pavilion is taking place? Exhibition Space required: YES NO Postal Code Factory Address (where applicable) Postal Address Box City Section 21 Other: Please Specify

Physical Address/es Address

Physical Address

Address City City Province Province Postal Code Name and Surname Name and Surname Name and Surname Facsimile Postal Code Title

Contact Person

CEO/MD/Owner

Title

Proposed Traveller (Designation)

Title

Telephone number

Alternative Numbers

Email Web site address

Cellular

Disclose information on related parties where the one party can exercise significant / insignificant / substantial / insubstantial influence over party in making financial and operating decisions or can exercise control or joint control over other party. Please refer to "Related Parties" on page 5 of the National Pavilion Guidelines, effective 1 April 2010. Name of related party Short description on the relationship

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Section B - Type of Activity of Applicant

Number of employees Total assets (Excluding fixed property) Membership at date of Application: OTHER BEE WOMEN OWNED Turnover last financial year Value of fixed property

SMME's

Export Council Indicate whether the organisation is a: Industry Association Joint Action Group

YES

NO

YES YES

NO NO

Section C - Previous Financial Assistance

Please indicate previous financial assitance received under any of the EMIA offerings during the last 3 years? (This includes both the Individual and Group offerings) Event/Mission Country Date EMIA Offering %

Section E - Declaration (To be completed by all applicants) AUTHORISED OFFICIAL OF THE ENTITY I, In my capacity as of
am aware of the fact that the information which I have submitted will have a material bearing on the adjudication of the application and if it, therefore, subsequently transpires that any information in the application and addenda was incorrect, or that certain information was omitted, The Department of Trade and Industry shall be entitled to withdraw or amend its approval and without prejudice to its rights, recover any amounts already paid or to withhold further payments due. I further undertake to furnish follow-up reports on the successes achieved by the visit no later than six months after my return. (Failure to submit the follow up reports will result in you/ your company/organisation being barred from further assistance under the EMIA scheme.) This application (with any addenda), if successful, will form part of your contract with The Department of Trade and Industry. Please Note: Cessions of the incentives granted are not allowed unless consented to in writing by the dti . Any cessions of these EMIA incentives or part thereof invalidate the contract from the date such cession is effected. The dti reserves the right to cede or transfer its rights to any other Government Agency. Indemnity: The organiser / participants indemnify and shall hold harmless the dti against any claims, damages, expenses and costs (including those asserted by third parties) directly or indirectly related to this National Pavilion and the Export Marketing and Investment Assistance provided to the National Pavilion participants by the dti, in delict, for breach of statutory duty or otherwise.

Signed (Authorised Official of Entity) Name in Print Date

Designation

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Appointment TO ACT AS A CONSULTANT (Only complete this part if you use an external consultant) The Board of Directors of declare that I/ We was/were appointed as a consultant to act on our behalf with regard to issues pertaining our participation in the EMIA Scheme of Trade and Industry. This appointment will remain in force until written notification of change by the entity. Physical address Postal address Telephone E-Mail address was appointed as a consultant to act on our behalf with regard to issues pertaining our participation in the EMIA Scheme of the dti. This appointment will remain in force until written notification of change by the entity. Signed (ONLY sign this part if an external consultant is used) Designation Facsimile

Name in Print Date

NB. This appointment does not authorise the consultant to sign any EMIA documents on behalf of the applicant. All documents submitted to EMIA must be signed by the applicant.

Section F - Document Checklist

Kindly ensure that all the required documentation is attached to the application in the following Refer to National order. Please tick the documentation submitted in the last column. Pavilion Guidelines
(a) Full colour product brochure (b) Electronic Product photos / images on CD disc in high definition (at least 300 dpi). These images are in addition to the product brochure. The cost of preparing these images is for the exhibitor's account). (c) A copy of the company's Export Registration certificate from Customs & Excise. applicable to domestic pavilions held in South Africa. Note: Not

(d) An original valid Tax Clearance Certificate, which must be obtained from SARS.The Tax Clearance Certificate should be valid at the time of approval of the application (+/- 4 months prior to the exhibition). Applicants are therefore advised to request Tax Clearance Certificates from SARS which are valid for a year. For applicants whose Tax Clearance Certificate has expired at the time of the approval process at EMIA, will be requested to lodge a new valid Tax Clearance Certificate before approval of their application can be given. (e) A copy of the Certificate of Incorporation and copies of all name changes effected. In the case of a sole proprietor a copy of a South African identity document. (f) A copy of a valid passport of the proposed traveler. applicable to domestic pavilions held in South Africa. Note: Not

(g) If you are a Commission Agent, please submit copies of agency agreements and brochures from three manufacturing entities, which you represent. (h) If you are an Export Trading House please supply details and brochures of at least three manufacturing entities represented and a letter of permission to represent these entities. (i) Latest audited financial statements, signed by the Directors and the report of the Auditors on the Auditor's letterhead. (j) Company profile and logo according to the attached template (company logo in high definition (at least 300 dpi) on a cd disc).

Important Information
Travel Arrangements the dti has appointed Preferred Service Providers, to the EMIA Scheme, for the provision of Travel services. These services include the management of air travel for SMME's and PDIs for the "National Pavilions & Mini National Pavilions" component of the EMIA Scheme. the dti / EMIA therefore makes the arrangements and bears the costs. Any extra costs incurred, over and above those benefits as approved by the dti / EMIA, will be for the applicants account. Preferred Service Supplies : DISCLAIMER Whilst every effort has been made to ensure that the Preferred Service Providers in the National Pavillions Guidelines and application forms are competent and efficient, the dti is discharged and exempted from all liability which might arise from all acts pertaining to the transport of samples and air travel arrangements.

Cancellation of National Pavilion and Mini Pavilion participation. IN THE CASE OF YOUR CANCELING YOUR PARTICIPATION THE FOLLOWING CONDITIONS APPLY: In the event of failure to participate in the approved trip, please ensure that the dti is informed timeously in writing, to this effect. The facsimile/email informing the dti of the intention to cancel should only be directed to the Director: Export Marketing, Mr Christiaan Saaiman (tel: 012 394 1021, fax: 012 394 0114/7 and email: Csaaiman@thedti.gov.za). Should your company fail to cancel its participation within 7 working days from signature date of the approval letter or fail to attend the exhibition, your firm will be liable for an R 50,000.00 cancellation fee payable to the dti. The cancellation of your participation after the issue of the air ticket to your firm by the Preferred Service Provider: Any cancellation fees are due directly to the travel agent. The second ticket will be solely for your account. The cancellation of your participation before selection of approved exhibitors: No cancellation fee.
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COMPANY PROFILE The dti requires the following information for the publication of the National Pavilion Brochure. Please use font: Arial 11. Title case Name of company as on the stand: Contact persons at the show and in SA: Designations: In SA: Postal address and code: P.O. Box South Africa Telephone: Fax: E-mail: Website: Main products which you manufacture/exhibit: Quality systems: (i.e. ISO) Desired co-operation: What are you doing at this show? Are you looking for wholesalers, agents manufacturers, importers, distributors, joint ventures? Brief history of company (max 100 words) Cover: date established, years in business, new products, new technology, production capacity, quality standards? (What makes you firm better than your competitors? Why should someone do business with your firm?) www. +27 ( ) +27 ( ) At show: In SA: At show:

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Desktop Export Readiness Questionnaire

Exporting has become a lucrative activity for many South African businesses, but all of them began brief questionnaire by making the critical decisions necessary to expand their market outside South Africa. The following is designed to help you make those fundamental decisions, or if you are already exporting, to help you identify additional information you may export more effectively.

Please note that although these questions require a simple yes/no answer, you are expected to back up your "yes" answers with substatiating evidence.

How to Score Yourself

Give yourself one point for each "Yes" answer, and zero for each "No" answer. YES 1 Your company has a product which has been successfully sold in the domestic market. (If yes, please provide proof by way of financial statements reflecting your domestic sales) 2 Your company has or is preparing an international marketing plan with defined goals and strategies. (If yes, please submit a copy of your international marketing plan - draft or otherwise.) 3 Your company has sufficient production capacity that can be committed to the export market. (If yes, please submit documentary proof: human resource capacity or manufacturing capacity etc) 4 My company has the financial resources to actively support the marketing of our products in the targeted overseas markets. (If yes, please provide proof by way of financial statements indicating financial resources) 5 My company is committed to developing export markets and is also willing and able to dedicate staff, time and resources to the process. (If yes, please indicate the strategy in place that will support this) 6 My company is committed to providing the same level of service given to our domestic customers. 7 My company has adequate knowledge in modifying product packaging and ingredients to meet foreign import regulations, food safety standards and cultural preferences. (If yes, please provide examples of knowledge in specific target markets) 8 My company has adequate knowledge in shipping its product overseas, such as identifying and selecting international freight forwarders, temperature management and freight costing. (If yes, please supply the relevant information as documented) 9 My company has adequate knowledge of export payment mechanisms, such as developing and negotiating letters of credits. (If yes, please substantiate with examples of knowledge levels) NO