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State / Province	Select Eastern Cape Free State Gauteng Kwazulu Natal Mobile Western Cape  *
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What industries do you have expertise in?	Select Accountant Accounting Advertising Agriculture Appliances Auditing Automotive & Transport Banking Beverages Business Services Charitable Organizations Chartered Accountant Chemicals Computer Hardware Computer Services Computer Software Construction Consumer Products Manufacturers Consumer Services Cosmetic Cultural Institutions Customer Service Debt counselling Education Electronics Energy & Utilities Entertainment Environmental Services & Equipment Events Executive Coaching Financial Services FMCG Food Foundations Franchising Garden/ landscaping Government Health Care Import and Export Industrial Manufacturing Insurance Interior Design IT Law Leisure Life Coach Media Membership Organizations Metals & Mining Pharmaceuticals PR Printing & design Publishing Real Estate Recruitment Restaurant / fast fo Retail Sales & Marketing Security Products & Services Telecommunications Equipment Telecommunications Services Training Transportation Services  *  year/s experience in this industry
What roles have you had in this industry?	Select Admin Advertising Branding Business relationship Communication Customer Service Financial IT Legal Marketing Merchandising Roles Operational PR Product Management Sales Strategic Technical operations Research Executive Coaching HR Training consulting Debt counselling web design SEO Accountant Investments  *  Other: Level: Select Business owner-large Small business owner Director Managing Director Senior Manager Middle Manager Junior/ supervisory manager Supervisor Operative Clerk
Industry 2 (if applicable)	Select Accountant Accounting Advertising Agriculture Appliances Auditing Automotive & Transport Banking Beverages Business Services Charitable Organizations Chartered Accountant Chemicals Computer Hardware Computer Services Computer Software Construction Consumer Products Manufacturers Consumer Services Cosmetic Cultural Institutions Customer Service Debt counselling Education Electronics Energy & Utilities Entertainment Environmental Services & Equipment Events Executive Coaching Financial Services FMCG Food Foundations Franchising Government Health Care Import and Export Industrial Manufacturing Insurance Interior Design IT Law Leisure Life Coach Media Membership Organizations Metals & Mining Pharmaceuticals PR Printing & design Publishing Real Estate Recruitment Restaurant / fast fo Retail Security Products & Services Telecommunications Equipment Telecommunications Services Training Transportation Services   year/s experience in this industry
What roles have you had in this industry?	Select Admin Advertising Branding Business relationship Communication Customer service Financial IT Legal Marketing Merchandising Roles Operational PR Product Management Sales Strategic Technical operations Research HR Training executive Coaching consulting Debt counselling web design SEO accountant investments    Other: Level: Select Clerk Business owner-large Small business owner Director Managing Director Senior Manager Middle Manager Junior/ supervisory manager Supervisor Operative
Industry 3 (if applicable)	Select Accountant Accounting Advertising Agriculture Appliances Auditing Automotive & Transport Banking Beverages Business Services Charitable Organizations Chartered accountant Chemicals Computer Hardware Computer Services Computer Software Construction Consumer Products Manufacturers Consumer Services Cosmetic Cultural Institutions Customer Service Debt counselling Education Electronics Energy & Utilities Entertainment Environmental Services & Equipment Events Executive Coaching Financial Services FMCG Food Foundations Franchising Government Health Care Import and Export Industrial Manufacturing Insurance Interior Design IT Law Leisure Life Coach Media Membership Organizations Metals & Mining Pharmaceuticals PR Printing & design Publishing Real Estate Recruitment Restaurant / fast fo Retail Security Products & Services Telecommunications Equipment Telecommunications Services Training Transportation Services   year/s experience in this industry
What roles have you had in this industry?	Select Admin Advertising Branding Business relationship Communication Customer service Financial IT Legal Marketing Merchandising Roles Operational PR Product Management Sales Strategic Technical operations Research Training HR Executive Coaching consulting Debt counselling web design SEO accountant investments    Other: Level: Select Clerk Business owner Small business owner Director Managing Director Senior Manager Middle Manager Junior/ supervisory manager Supervisor Operative Business owner-large
If other industry, please specify
At what capacity would you like to be involved? *	Once-off Advice (+- 2 hrs per client)  Regular Mentor (regular meetings +- 1 hour every 1 - 2 weeks till complete)  Case Manager (the main consultant co-ordinating the team of mentors. Time: +- 1 hour every 1 - 2 weeks till complete)  Part of Crisis Team (team based intensive hand holding - everyday contact with business in crisis till complete)  Networker (helping to open important doors for clients if and when necessary)  Lecturer Expert (1 lecture per year / write articles for our Best lecture series)  Radio Guest Expert (occassional participation on ChaiFm on the OrtJet show)  Network Participant (attend OrtJet networking events)  Jet Jobs Mentor (assisting people with finding jobs)  Donor: Annual Budget  Donor: Specific Event  Coaching
What kind of businesses would you like to work with?	Start-up  Existing- seeking growth  Existing- struggling  In crisis
If other, please specify
In what area can you best help a business? *	Advertising  Branding  Budgeting  Business plans  Business Registration  Cash flow  Costings  Customer Servive  CV Writing  Executive Coaching  Financial projection  Innovation  Labour Law  Legal  Life Coaching  Marketing  Networking  Operations  PR  Project Management  Publishing  Sales  Social Networking  Strategy  Tax  Website
If other, please specify
Do you wish to mentor businesses in the Jewish community?	Yes    No *
Do you wish to mentor businesses in the broader non-Jewish community?	Yes    No *
Does your business require BBBEE points for Skills Development, Enterprise Development and/or Socio-Economic Development?	Yes    No
How many hours can you realistically devote to OrtJet per month at the moment
Are you interested in attending group coaching/shared knowledge sessions in respect of the businesses you are mentoring? (facilitated group brainstorming session)	Yes    No
If yes, how often?	Select Once per month Every second month Every quarter Twice per year
How did you hear about ORT JET?	Select Magazine Newspaper Other Pamphlet Poster Word of Mouth
What communication would you like to receive from OrtJet?	Chai FM Show info  Networking Events  Newsletter  Skills Training