Please complete the form below.

All fields marked with * are required

First Name *

First Name *

WhatsApp Number *

Address Line 1 *

City *

Province *

Postal Code *

Date of Birth *

Personal Email Address *

My Mentor’s name *

Digital Global Community credentials
  a) Login to DGC to verify credentials: www.digitalgrowthcommunity.mykajabi.com (opens in a new window/tab)
  b) Once verified, enter credentials here:
  Username (email address) *
 
  Password *
 

Please insert at least one preferred domain name (we recommend something like earnonlinewithyourfirstname.com).
We will attempt to register your domain name in the order you have provided but this cannot be guaranteed as they may all be in use.
If this is the case, we will contact you for alternatives.

My Preferred Domain Name 1 *

My Preferred Domain Name 2

My Preferred Domain Name 3

My Preferred Password * (this will be used as your password for your domain, your professional email address, your systeme account and your PayPal account. This password must contain at least 1 lowercase letter, 1 uppercase letter, 1 number, 1 special character [* or # or !])

Link to your Facebook page

Link to your Instagram page

Link to your TikTok channel

Bank

Account Holder

Account Number

Branch Name

Swift Code

Submit a brief bio/story that you would like presented on your lead capture page. This bio/story is personal to you and should convey a little about yourself and/or where you currently are in life. It can also explain why you have decided to take this step into Digital Marketing. *

Submit a brief bio/story that you would like presented in your campaign emails. As above, this bio/story is personal to you and should convey a little about yourself and/or where you currently are in life. It can also explain why you have decided to take this step into Digital Marketing. *

A photo of yourself for your webpage *

An optional second photo of yourself/family for your webpage

I have verified my DGC account credentials by logging into the platform.

I agree to purchase my yearly domain and email hosting from SilverFoxIt and that I will receive the banking details for this to the value of R750 (this is a yearly fee) via WhatsApp from Andre. Andre will only commence the setup once these funds have reflected in SilverFoxIT’s bank account.

I agree to let Andre from SilverFoxIT have full access to my DGC account for the purpose of setting up my DGC system. I further agree that once Andre has notified me that setup is completed, it is my responsibility to ensure that my system/website is functioning as expected and will not hold Andre or SilverFoxIT responsible for any errors and/or omissions. After setup completion I may update my various OTP settings and/or passwords.

I acknowledge that Andre from SilverFoxIT is being tasked to perform a once-off default system setup as per the DGC lessons and not any ongoing maintenance/updating of my system. Andre is contactable between 9am and 5pm Monday to Friday. If I require any further assistance, either technical or marketing related, I will request such assistance from my Mentor and/or the DGC Community.