Obscurian Citizenship Application

Obscurian Citizenship Application
Name*

First nameSurname
Date of Birth

MonatTagJahr
Datum
Place of Birth*
Sex*

MaleFemaleOther
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 number
Are you a citizen of any other state(s)?*

Yes (please name all states of which you are a citizen in the field below, including all Macro and Micronations)No
!You can only acquire Obscurian citizenship if you hold less than 3 other citizenships!
(Fill in if you've chosen "Yes" in the previous question) I'm a citizen of:
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?*

YesNo
Signature*

Löschen
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.
Current Occupation
Should be Empty: