This application form is the first step in the application process and is designed to provide us with more information on the applicant.   

LandMark follows a systematic approach to franchising, in that all applications will be assessed in terms of our national roll out plan.  Please be clear on the area that you are interested in.

Please take specific note that it is part of the LandMark franchise policy not to consider opening a LandMark franchise in competition with, or within the immediate location of existing agricultural retail outlets. (Examples: Senwes, Suidwes, NTK, NWK, VKB, GWK, TWK, etc.)

Fields marked with (*) are required

Preferred area of the franchise:*

Physical Address of the store:*

Existing / New store:

Surname:*                       

First Name:*

ID Number:*

Residential Address:

Postal Code:

Postal Address:

Postal Code:

Telephone Numbers       

Business :

Home:

Cell:

Other:

Email address:*