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It is possible that in the future a new form for citizenship in Freedomia will be created. Here is the proposed design:
The Republic of Freedomia
Citizenship/Naturalization Application Form
Type your answers using CAPITAL letters.
Do not modify the questions or the application itself in any way, shape, or form—application WILL be nullified.
Part 1: Legal name
All new citizens are permitted to use a pseudonym if they wish, however, please first include your real name. If you plan on changing your name in Part 2, still add in your current name.
First name:
Last name:
Middle name:
If you wish to use a pseudonym, please add it in the space below.
Part 2: Name change
If you do not wish to change your name at this time, please move on to Part 3. Note: A name change will not apply in other countries and does not count as a pseudonym. Please carefully decide whether or not you wish to change your name.
Would you like to change your name?
If you wish to change your name, please add it exactly as you want it in the space below. Include the first, middle, and last name. Do not use abbreviations, nicknames, or anything of the kind.
Part 3: Personal information
Country of birth:
Current marital status:
Email address:
How else may you be contacted?
Gender:
Height:
Weight:
Race: (Choose one or more: White, Asian, African-American, Native American, Native Alaskan, Pacific Islander)
Natural hair color:
Natural eye color: (If you use contacts that change eye color, specify below)
Do you use contacts that change eye color? What color?
Part 4: Confirmation
I affirm that the information I have provided is correct, under penalty of perjury of the Republic of Freedomia.
Signature Date (mm/dd/yy)
The Republic of Freedomia
Citizenship/Naturalization Application Form
Type your answers using CAPITAL letters.
Do not modify the questions or the application itself in any way, shape, or form—application WILL be nullified.
Part 1: Legal name
All new citizens are permitted to use a pseudonym if they wish, however, please first include your real name. If you plan on changing your name in Part 2, still add in your current name.
First name:
Last name:
Middle name:
If you wish to use a pseudonym, please add it in the space below.
Part 2: Name change
If you do not wish to change your name at this time, please move on to Part 3. Note: A name change will not apply in other countries and does not count as a pseudonym. Please carefully decide whether or not you wish to change your name.
Would you like to change your name?
If you wish to change your name, please add it exactly as you want it in the space below. Include the first, middle, and last name. Do not use abbreviations, nicknames, or anything of the kind.
Part 3: Personal information
Country of birth:
Current marital status:
Email address:
How else may you be contacted?
Gender:
Height:
Weight:
Race: (Choose one or more: White, Asian, African-American, Native American, Native Alaskan, Pacific Islander)
Natural hair color:
Natural eye color: (If you use contacts that change eye color, specify below)
Do you use contacts that change eye color? What color?
Part 4: Confirmation
I affirm that the information I have provided is correct, under penalty of perjury of the Republic of Freedomia.
Signature Date (mm/dd/yy)
