Petition to leave planet Earth

i Provide your personal details, such as your name and contact information, to help us tailor your experience. Your data will be securely stored and used in accordance with our privacy policy.

Personal Information

Contact Information

i Select your galactic race from menu. This information helps us accommodate any specific interplanetary needs.

Race Information

i Enter your current residential address, including planet, sector, and quadrant. This will be used for official correspondence.

Address Information

Country
i List your current and past employment details, including your role and organization. This helps us assess your professional background.

Employment Information

i Provide details of your educational qualifications, including institutions and degrees. Highlight any relevant interstellar studies.

Education Information

i List any special skills or certifications that may be relevant for interplanetary travel. Include technical, linguistic, or survival skills.

Skills & Qualifications

i Select your galactic race from menu. This information helps us accommodate any specific interplanetary needs.

Professional References

i Specify your intended destination, purpose of travel, and duration of stay. Be as detailed as possible.

Planned Travel Information

i List any prior space travel experiences, including destinations and dates. This helps us evaluate your readiness for intergalactic journeys.

Previous Travel Information

i Provide proof of financial stability to cover travel expenses and emergencies. This ensures you can sustain yourself during the trip.
i Include details of your intergalactic medical insurance coverage. This is mandatory for all off-planet travelers.
i Provide accurate measurements of your body, head, and feet. This information is essential for customizing your spacesuit.

Physical Information

Additional Information

1. Personal Information
First Name Last Name Gender
Date of Birth Place Of Birth Nationality
2. Contact Information
Email Address Confirm Email Phone Number Alternative Phone
Preferred Contact Method Emergency Contact Name Relationship Emergency Contact Phone
3. Additional Information
Race
Where, when and under what circumstances did he end up on planet Earth?
Who did you collaborate with on planet Earth?
What else would you like to tell us about yourself?
4. Address Information
Solar System Planet
Street Address Address Line 2
City State/Province
ZIP/Postal Code Country
Previous Street Address Previous Address Line 2
Previous City Previous State/Province
Previous ZIP/Postal Code Previous Residence Type
Years at Current Address Months at Current Address
5. Employment Information
Current Employment Status Occupation/Job Title Current Employer
Work Phone Employer Address
Employer City Employer State/Province
Employer ZIP/Postal Code Employer Country
Employment Start Date Years at Current Employer Months at Current Employer
Annual Income Income Type
Previous Employer Previous Job Title
Previous Employer Address Previous Employer City
Start Date End Date
6. Education Information
Highest Level of Education
High School Name High School Location (City, State/Country) Year of Graduation Diploma Received
College/University Name College Location (City, State/Country) Degree Earned Major/Field of Study Minor (if applicable) Start Year End Year (or Expected) GPA
Graduate School Name Graduate School Location Graduate Degree Field of Study Start Year End Year (or Expected) GPA
7. Skills & Qualifications
Professional Skills Technical Skills
Languages Spoken Certifications & Licenses
8. Professional References
Reference 1 - Full Name Relationship Company Phone Number Email
Reference 2 - Full Name Relationship Company Phone Number Email
Reference 3 - Full Name Relationship Company Phone Number Email
9. Legal Information
Criminal Record
10. Planned Travel Information
Solar System Planet Purpose of Travel Planned Date of Travel Duration of Travel (days)
11. Previous Travel Information
Universe Solar System Planet Purpose of Travel Date of Travel End of Travel
12. Financial Security and Medical Insurance
Financial Security Medical Insurance
13. Physical Information
Clothing Size Shoe Size (EU) Head Circumference (cm)
14. Additional Information
Additional Information or Special Circumstances How did you hear about us? If referred, by whom?