Application form.cdr

NSK STATE PASSPORT APPLICATION FORM
1. Surname or
family names:
30mmx40mm
2. First name:
PHOTO
3. Day of birth (day, month, year):
4. Place of birth
(City, Country):
glue or staple
one photo here
Permanent residence:
5. Street (including
appartment No.):
6. City:
7. Province
and postal:
8. Country:
9. Profession:
10. Home telephone No.:
11. Business telephone No.:
12. E-mail:
13. Sex:
Female
14. Blood group:
Male
15. Colour of hair:
16. Colour of eyes:
17. Height:
18. Previous/parallel citizenship:
19. Are you or have you been a member of any particular political or art group or organisation?
If yes, name them:
I ____________________________________________ being of sound mind and body, hereby declare that the
information provided above is true and correct. By signing this form and becoming a passport bearer and citizen of NSK
I commit myself to the principle that I will not abuse document for any criminal, ideological, artistic, religious or
political purpose not in compliance with the principles of NSK, or which would otherwhise threaten its reputation and
good name.
We ask for your permision to use your NSK passport Application Form for all kinds of artistic projects and public use
without limitation in time, territory and scope.
No
Yes
Date of application:
Signature:
FOR OFFICIAL USE ONLY (DO NOT WRITE IN THIS SPACE)
Passport issued
Day, month, year:
Issued by:
Passport No.:
Send the application form, together with two photographs, to the following address:
NSK INFORMATION CENTER, P.P. 101, SI-1001 Ljubljana, Slovenia, NSK.