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* 1. Name of organisational representative

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* 2. Title or position

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* 3. Region/s located

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* 4. Email address (personal email addresses, such as Gmail, will be disqualified)

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* 5. Cellphone number

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* 6. Total number of vehicles in your organisations fleet

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* 7. Does your organisation have a fleet safety strategy in place?

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* 8. Does your organisation monitor safety procedures within your organisation?

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* 9. Does your organisation use telematics to track and improve road safety within the fleet?

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* 10. Has your fleet safety strategy reduced your costs?

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* 11. You hereby declare and confirm that you, as the person/entity/body/individual/company who is providing information do hereby agree and understand that any/all information supplied or given to the service provider, is in compliance with the POPI Act and completion of the form is a declaration of consent.

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