Create Your BActive Profile
STEP 1/3
| PERSONAL INFORMATION
* Indicates compulsory fields
*Email Address:
IMPORTANT: The email address that you enter will be used by you to sign into the BActive system
*First Name:
*Surname:
Are you a South African citizen?
YES
NO
*ID Number:
Date of Birth:
November 2003
Sun
Mon
Tue
Wed
Thu
Fri
Sat
44
26
27
28
29
30
31
1
45
2
3
4
5
6
7
8
46
9
10
11
12
13
14
15
47
16
17
18
19
20
21
22
48
23
24
25
26
27
28
29
49
30
1
2
3
4
5
6
Today
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
OK
Cancel
Gender:
MALE
FEMALE
*Province:
Eastern Cape
Free State
Gauteng
KwaZulu-Natal
Limpopo
Mpumalanga
North West
Northern Cape
Western Cape
Non-South African
*Cellphone Number:
Home Number:
Work Number:
Postal Address:
Home Address:
NEXT
