Obscurian Citizenship Application

Obscurian Citizenship Application
Name

First nameSurname
Date of Birth

MonatTagJahr
2 digit month, 2 digit day, 4 digit yearDatum
Place of Birth
Sex
Valid E-mail
example@example.com
Address

Street and house number

Street Address Line 2

City*Country*

Postal / Zip Code
Discord Account
Required to participate in Parliamentary meetings!
Phone Number
Please enter a valid phone numberFormat: (000) 000-0000.
!You can only acquire Obscurian citizenship if you hold less than 3 other citizenships!
Other Citizenships (Macro and Micronational) IMPORTANT: LIST ALL CITIZENSHIPS HERE, INCLUDING THOSE OF RECOGNIZED STATES SUCH AS GERMANY, POLAND, US, BRAZIL, Etc.!!!!:
Why do you wish to become a citizen of Obscurium?
Do you pledge your allegiance to the Basic Law of the United Republic of Obscurium?
Signature
Please understand that any false information you deliberately give us within this form may disqualifiy you from citizenship.

Ministry of Customs and Immigration of the United Republic of Obscurium Data Protection Disclaimer: Your data and inofmations will not be given to any third party and will only be accesible to you and the Government of Obscurium.
Your submitted form will be deleted once your acquire or fail to acquire Obscurian Citizenship or after one month after a reply to a Citizenship application has been sent to you via email.

Current Occupation
Should be Empty:

Arabic	Hebrew	Polish
Bulgarian	Hindi	Portuguese
Catalan	Hmong Daw	Romanian
Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian