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Fill in the form below to nominate your friends and family:A nominated lady should earn more than R10 000 per month and must be between the ages of 25 and 65.Your name:* Your first name Your surname Your contact number:*1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R10 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R20 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R30 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R40 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R50 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R60 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R70 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R80 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R90 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R100 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R110 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R120 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R130 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R140 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R150 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R160 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R170 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R180 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R190 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R200 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R210 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R220 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R230 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R240 and an entry into the R30 000 competition.Would you like to refer another lady to earn an extra R10 and another entry into the competition?* Yes No 1. Your referral's name:* First name 2. Your referral contact number:*3. Your relationship to this lady:*She is myAcquaintanceAuntClientColleagueCousinDaughterDaughter-in-LawFamily-in-LawFriendGranddaughterGrandmotherMotherMother-in-LawNiecePartnerSisterSister-in-LawOtherShe is my: Well done! You have now earned R250 and an entry into the R30 000 competition. Δ
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