Express an interest to be an ActionSA MP or MPL

GET INVOLVED

First Name

Last Name

ID Number

ActionSA Membership Number

Phone Number

Province

Municipality - Eastern Cape

Municipality - Free State

Municipality - Gauteng

Municipality - KwaZulu Natal

Municipality - Limpopo

Municipality - Mpumalanga

Municipality - Northern Cape

Municipality - North West

Municipality - Western Cape

Please select whether interested in the position of MP or MPL

MP MPL

NB! This form does not constitute an application to be a candidate but an Expression of Interest.