Upload a collection sheet for a petition

The collection sheet is uploaded for this petition:

Petition: Petition for Accountability and Protection of Patients’ Rights at Mitchell’s Plain District Hospital
Region: Western Cape
Recipients: Western Cape Provincial Parliament

(Not the right petition? Then click here.)

1. Select file

Upload each collection sheet individually as a file. Use our template for this petition to collect signatures.

2. Number of signatures

3. Enter signature details (optional)

No. 1.
Postal code
City
Country
Email
No. 2.
Postal code
City
Country
Email
No. 3.
Postal code
City
Country
Email
No. 4.
Postal code
City
Country
Email
No. 5.
Postal code
City
Country
Email
No. 6.
Postal code
City
Country
Email
No. 7.
Postal code
City
Country
Email
No. 8.
Postal code
City
Country
Email
No. 9.
Postal code
City
Country
Email
No. 10.
Postal code
City
Country
Email
No. 11.
Postal code
City
Country
Email
No. 12.
Postal code
City
Country
Email
No. 13.
Postal code
City
Country
Email
No. 14.
Postal code
City
Country
Email
No. 15.
Postal code
City
Country
Email
No. 16.
Postal code
City
Country
Email
No. 17.
Postal code
City
Country
Email
No. 18.
Postal code
City
Country
Email
No. 19.
Postal code
City
Country
Email
No. 20.
Postal code
City
Country
Email
No. 21.
Postal code
City
Country
Email
No. 22.
Postal code
City
Country
Email
No. 23.
Postal code
City
Country
Email
No. 24.
Postal code
City
Country
Email
No. 25.
Postal code
City
Country
Email
No. 26.
Postal code
City
Country
Email
No. 27.
Postal code
City
Country
Email
No. 28.
Postal code
City
Country
Email
No. 29.
Postal code
City
Country
Email
No. 30.
Postal code
City
Country
Email
No. 31.
Postal code
City
Country
Email
No. 32.
Postal code
City
Country
Email
No. 33.
Postal code
City
Country
Email
No. 34.
Postal code
City
Country
Email
No. 35.
Postal code
City
Country
Email
No. 36.
Postal code
City
Country
Email
No. 37.
Postal code
City
Country
Email
No. 38.
Postal code
City
Country
Email
No. 39.
Postal code
City
Country
Email
No. 40.
Postal code
City
Country
Email
No. 41.
Postal code
City
Country
Email
No. 42.
Postal code
City
Country
Email
No. 43.
Postal code
City
Country
Email
No. 44.
Postal code
City
Country
Email
No. 45.
Postal code
City
Country
Email
No. 46.
Postal code
City
Country
Email
No. 47.
Postal code
City
Country
Email
No. 48.
Postal code
City
Country
Email
No. 49.
Postal code
City
Country
Email
No. 50.
Postal code
City
Country
Email

Danger!

Uploading signatures is only possible until 1 day after the collection ends!

City of signature

You can provide the postal code, city, and email address for each paper signature. Please do not enter the signatories' names.

Paper signatures are valid even without a location specified. However, the signatures will not be displayed on the map and will not be considered when calculating the quorum.

All signatures are taken into account for the total number of signatures.

Notice

If you use collection forms not created by openPetition , you must include your name and address. A privacy policy must also be included:

Data privacy policy
This signature sheet will be uploaded to https://www.openpetition.org/za as an image. Your postal code and city will be saved so your signature can be counted. If you would like to stay informed by email, please consent to the storage of your email address. You can revoke this consent at any time.

Help us to strengthen citizen participation. We want to support your petition to get the attention it deserves while remaining an independent platform.

Donate now