Step 1 : Enter your personal information on application form.  Fill in all the blanks.

-Personal Information-

First Name:   Middle Initial:   Last Name:

        D.O.B:  Height:  Inches:   Weight: Sex:

  Eye Color: Hair Color:  Mothers Name: (optional)

Ethnicity Marital Status:  Spouses Name: (optional)

-Residence / Address-

Address 1: 

Address 2: 

            City:  State:  Zip Code:

Current Citizenship: 

-Contact Info-

Home Phone:--  Home Fax:--  E-Mail

 

INSTRUCTIONS:                                                                                           APPLICATION FEE  $15.00

STEP 1:  Fill out Dual Citizenship Application completely.   All information is needed for personal identification and statistical analysis purposes.  The government of the Republic of Anodyne will hold all information in confidence, and does not rent or sell it's citizen's personal information to commercial interests.  

STEP 2:  Click on PayPal link to submit the $15.00 Application fee.

 

 

STEP 3:  Click on SUBMIT Button to submit completed form for processing.      

I, the undersigned, attest, swear, and affirm that by pressing the "submit" button the information on this application is true, correct, and complete; that this application is made in good faith with no purpose of evasion, deceit or violation of any governmental law, rule, or regulation.