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Section A: Applicant Details

Full Name (as per ID) ID Number

Please ensure your ID number is correct. It will be used for eligibility verification.

Date of Birth Gender SelectFemaleMaleNon-binaryPrefer not to say Contact Number Email Address Residential Address

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Section B: Electoral & Geographic Details

Province Select ProvinceEastern CapeFree StateGautengKwaZulu-NatalLimpopoMpumalangaNorthern CapeNorth WestWestern Cape Municipality Ward Number Voting Station (optional)

Are you a registered voter in this ward?

YesNo

Check your voter registration status

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Section C: Position Applied For

Select the position(s) you wish to apply for:

Ward CouncillorProportional Representation (PR) CouncillorBoth Ward and PR Councillor Preferred Municipality / District for PR position

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Section D: Political & Community Experience

Brief summary of community activism, leadership roles, or political experience (maximum 2 pages)

Include community organisations, leadership roles, civic initiatives, volunteer work, political memberships and achievements.

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Section E: Motivation Statement

Why do you wish to stand as a candidate for ACT? (maximum 1 page)

Explain your commitment to ACT values, how you plan to serve your community and your vision for local government.

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Section F: Ethical & Legal Declarations

I declare that I have no criminal record I confirm that the information provided is true and correct I commit to uphold the values, constitution and disciplinary code of ACT I understand that nomination is subject to vetting and approval by ACT structures

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Section G: Required Attachments

Document Checklist (required):

Certified copy of South African IDProof of voter registrationProof of residenceCurriculum Vitae (max 3 pages)Proof of payment (R1000 non-refundable contribution)

Please upload the required documents below.

Certified Copy of South African ID Proof of Voter Registration Proof of Residence Curriculum Vitae (Maximum 3 Pages) Proof of Payment (R1000 Contribution)

Accepted formats: PDF, DOC, DOCX, JPG, JPEG, PNG. Maximum file size per document: 20MB.

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Section H: Final Confirmation and Signature

Digital Signature (type your full legal name) I confirm that all information provided in this application is true and accurate. I consent to ACT collecting and processing my personal information for candidate vetting and selection in accordance with POPIA.