Reviving Township Economies KZN Floods
Existing Beneficiaries

One business at a time

Please complete the form below


  • 1. Contact Information

  • If you selected i am a existing business owner , go to question 1.3
    If you selected i am a agent of a partner , go to question 1.2
    If you selected i am an Afrika Tikkun employee , go to question 1.2




  • 2. Exclusion Criteria



  • 3. Business Information

  • Street Name & NoSuburb/ TownLocal MunicipalityPostal Code 
  • 3.6. How many employees in the business (including the owner)?

  • WRITE NUMBER DIGITS ONLY (leave no spaces).
  • WRITE NUMBER DIGITS ONLY (leave no spaces).
  • 4. Incident Information



  • WRITE NUMBER DIGITS ONLY (no currency sign, no commas, leave no spaces).
  • Drop files here or
    Accepted file types: pdf, xlsx, xls, xlsm, xml, jpg, gif, png, pdf, mp4, jpeg, mov, jpeg, Max. file size: 512 MB.