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:
September 2003
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Today
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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:
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