Will you support the DA for change in 2024?

PLEASE BE ADVISED THAT ANY INFO CAPTURED HERE, IS PRIVATE AND CONFIDENTIAL. ONLY THE DEMOCRATIC ALLIANCE WILL HAVE THIS INFORMATION, AS IT GIVES THE DA AN INSIGHT AS TO WHERE AND HOW WE ARE DOING IN THE POLLS.

Will you support the DA for change in 2024?

YesNoMaybe

Are you registered to vote?

YesNo

If you are not registered to vote, would you like to be assisted?

YesNo

Please fill in your personal details below

First Name (required)

Last Name (required)

Physical Address(required)

ID Number(required)

Cellphone Number(required)

Email Address(required)

Electronic signature acceptance(required)