Personal Information

Full Name:
Date of Birth:
Email Address:
Phone Number:
Mailing Address:

Membership Type

Individual Membership
Family Membership
Student Membership
Corporate Membership

Interests

Deep Space Exploration
Consciousness Uploading
Android Technologies
Artificial Intelligence
Digital Intelligence Rights

Skills and Contributions

Agreement

I hereby apply for membership in Altronaut and agree to abide by its bylaws and code of conduct.