Burner Bio Form Old

Fields will be Merged with previously collected where available.

Name*

First

Last 2) Username*

Create your AfrikaBurn login name 3) Password*

Enter Password

Confirm Password Strength indicator

--- 4) Email* No longer required as already captured on the questionnaire

Secondary Email Address Many people have 2 email accounts, we will only use the second one to help you if you loose access to the first or linking your information where people have add you using the secondary email address.
ID number (or Passport number if not an SA citizen)*

South African ID Number

International Passport Select either your SA ID or your international passport number.

SA ID

Passport Number

Nationality

6b) City

Date of Birth*

(please CLICK YEAR FIRST, thanks)

Gender*

Male

Female

Other 9) Mobile phone number

Don't want to enter your number for privacy reasons? No problem - just enter 'NO', and proceed, thanks. (just be aware that once your ticket is confirmed, one of the ways that's done is by a text to your number - and if there are any last-minute updates, which are also sent via mail & text, a text is the best way to get it to you soonest)

end of page PAGE BREAK top of new page History Please let us know about your previous participation at AfrikaBurn. (been part of a Theme Camp, Artwork, Performance or Mutant crew? Volunteered?)

Tribe 2007 2007 (Tribe) Involvement How did you participate? Did you volunteer, and if so, how?

Power 2008 2008 (Power) Involvement How did you participate? Did you volunteer, and if so, how?

Time 2009 (Time) Involvement