Initiate Registration Form

Initiate Registration Form

(Form 1-a) v.1.0.01
Initial Agreement*
Please verify that you are human.*

Member Contact Information
Member ID Number:*
Name (as it appears on your birth certificate):*
NeoName:*
National ID Number:*
ID/Passport Number:*
Address:*
Phone Number:*

Country CodePhone Number
Email:*
example@example.com
Signature 1:*

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Date 1:*

MonthDayYear

Basic Information
Date of Birth:*

MonthDayYear
Race:*
Gender (at birth):*
Gender Identity/Sexuality:*
Work Status:*
Relationship Status:*

Legal Contact Information
How old are You?:*
Parent/Legal Guardian 1:*
Parent/Legal Guardian 1 Address:*
Parent/Legal Guardian 1 Phone #:*

Country CodePhone Number
Parent/Legal Guardian 1 Email:*
example@example.com
Add a Second Parent/Legal Guardian?:*
Parent/Legal Guardian 2:*
Parent/Legal Guardian 2 Address:*
Parent/Legal Guardian 2 Phone #:*

Country CodePhone Number
Parent/Legal Guardian 2 Email:*
example@example.com
Are You or Your Partner Pregnant?:*
Other Parent to Be:*
Other Parent to Be Address:*
Other Parent to Be Phone #:*

Country CodePhone Number
Other Parent to Be Email:*
example@example.com
Tell Us About Your Fetus/Feti:*

0/2500
Add an Emergency Contact?:*
Emergency Contact:*
Emergency Contact Address:*
Emergency Contact Phone #:*

Country CodePhone Number
Emergency Contact Email:*
example@example.com
Do you have any children?:*
Child 1:*
Child 1 Address:*
Child 1 Phone #:*

Country CodePhone Number
Child 1 Email:
example@example.com
Child 2:*
Child 2 Address:*
Child 2 Phone #:*

Country CodePhone Number
Child 2 Email:
example@example.com
Child 3:*
Child 3 Address:*
Child 3 Phone #:*

Country CodePhone Number
Child 3 Email:
example@example.com
Child 4:*
Child 4 Address:*
Child 4 Phone #:*

Country CodePhone Number
Child 4 Email:
example@example.com
If Registering More than 4 Children, Please use this text field to list any additional children:*

0/2500
Register a partner?:*
Partner:*
Partner Address:*
Partner Phone #:*

Country CodePhone Number
Partner Email:*
example@example.com
Register a pet?:*
Tell Us About your Pets:*

0/2500
Veterinarian Office Name:
Veterinarian Name:
Veterinarian Address:
Veterinarian Phone #:

Country CodePhone Number
Veterinarian Email:
example@example.com
Signature 2:*

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Date 2:*

MonthDayYear

Tell Us More About Yourself.
Desired Type of Involvement in Ultimatarianism?:*

SpiritualSecularBusiniess
List Your talents, skills, certifications and achievements:*

0/2500
Tell Us About Your Academic Career:*

0/2500
Tell Us About Your Professional Career:*

0/2500
What do you want to achieve by joining us?:*

0/2500
What does being better mean to you?:*

0/2500
Upload Verifying Documents:*

Your files are safely stored in our encrypted database, for your safety.
Cancelof
Signature 3:*

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Today's Date 3:*

MonthDayYear
Please Agree to the Terms and Conditions of Your Initiation:*

I agree to the Terms and Conditions of My Initiation. I Look Forward to Being the Best Part of Making Myself Better.I don't agree to the Terms and Conditions of My Initiation and am a BIG POOPY HEAD!

You Are On The Path Now. You Are Your Strongest Asset.
Every Yesterday Is A Look At Who You Used To Be. Become The Person your Past Self Wishes It Could Be.
Every Today Is A New Chance To Be Better Than Yesterday. Become The Person Your Present Self Can Rely On To Get Shit Done Today.
Every Tomorrow Is Another Day To Be Even Better. Become The Person That Your Future Self Can Thank For The EZ Mode Cheat Code They Use In Their Life.
Always Be Better. There Is No Hitting 100%. Once You Hit 100%, You’ll Be Able To See That The Next Step Is Just In Sight, A Little Closer And You're Just Getting Warmed Up For Bigger And Better Things.
Everything Behind You Was Effectively Your Tutorial Level. Now It’s Time To Play The Game For Real. Now Get Good Or Get Fucked LOL.
Should be Empty:

Initiate Registration Form

Member Contact Information

Basic Information

Legal Contact Information

Tell Us More About Yourself.

You Are On The Path Now. You Are Your Strongest Asset.

Every Yesterday Is A Look At Who You Used To Be. Become The Person your Past Self Wishes It Could Be.

Every Today Is A New Chance To Be Better Than Yesterday. Become The Person Your Present Self Can Rely On To Get Shit Done Today.

Every Tomorrow Is Another Day To Be Even Better. Become The Person That Your Future Self Can Thank For The EZ Mode Cheat Code They Use In Their Life.

Always Be Better. There Is No Hitting 100%. Once You Hit 100%, You’ll Be Able To See That The Next Step Is Just In Sight, A Little Closer And You're Just Getting Warmed Up For Bigger And Better Things.

Everything Behind You Was Effectively Your Tutorial Level. Now It’s Time To Play The Game For Real. Now Get Good Or Get Fucked LOL.