Registration form
Registration for an Unconditional Basic Income.
Earths address *
First Name in English *
Last Name (Surname) in English *
Middle Name (Father's name) in English
Date of Birth *
MM
/
DD
/
YYYY
What countries of citizenship do you have? *
Please specify one by one in order of obtaining citizenship.
First Name in native language *
Use the language as in the passport
Last Name in native language *
Use the language as in the passport
Middle Name in native language
Use the language as in the passport
Mobile phone number *
E-mail address *
Main e-mail address.
Face photo *
Required
Passport Scan *
Required
Face photo with passport *
Photo of a face with a passport in his left hand next to his face.
Required
Passport Country *
What country issued a passport?
Passport series
Passport number *
Date of issue of passport *
MM
/
DD
/
YYYY
Submit
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