IP/Proxy Check Shareholdership Application: AussieJWH#1208

DEPARTMENT OF SHAREHOLDERSHIP
SHAREHOLDER MEMBERSHIP APPLICATION

Did you submit this using an IP Proxy?  No

Nation in Lazarus: New Jacobland

WA Nation: New Jacobland

NS Identities: I did a bit of RP at the Western Isles, but that's the only region I've been really involved in.

Have you been accused of any crime/s in other region/s?: Not really, I did get ejected from FWO for saying the RMB was dead.

Have you participated in any other region/s?: The Western Isles (as above)

Do you affirm this information is correct?: Yes

Oath of Membership: From this time forward, I voluntarily without mental reservation or purpose of evasion, pledge my loyalty to Lazarus and her people, whose community ideals I share, whose rights and liberties I respect, and whose laws I will uphold and obey.

Survey (optional):

What areas of the region are you most interested in?: Culture & Role-playing i.e. World building and regional events,Legislature i.e. discussing and proposing laws,Foreign Affairs i.e. being an ambassador to another region

IP/Proxy Check: Failed

Nation no longer in region.