Contact Information
                                        
                                            Full Name: 
                                        
                                        
                                            
                                        
                                        
                                            Nationality : 
                                        
                                        
                                            
                                                
                                                    Afghanistan
                                                 
                                                
                                                    Albania
                                                 
                                                
                                                    Algeria
                                                 
                                                
                                                    Andorra
                                                 
                                                
                                                    Angola
                                                 
                                                
                                                    Antigua and Barbuda
                                                 
                                                
                                                    Argentina
                                                 
                                                
                                                    Armenia
                                                 
                                                
                                                    Australia
                                                 
                                                
                                                    Austria
                                                 
                                                
                                                    Azerbaijan
                                                 
                                                
                                                    Bahamas
                                                 
                                                
                                                    Bahrain
                                                 
                                                
                                                    Bangladesh
                                                 
                                                
                                                    Barbados
                                                 
                                                
                                                    Belarus
                                                 
                                                
                                                    Belgium
                                                 
                                                
                                                    Belize
                                                 
                                                
                                                    Benin
                                                 
                                                
                                                    Bhutan
                                                 
                                                
                                                    Bolivia
                                                 
                                                
                                                    Bosnia and Herzegovina
                                                 
                                                
                                                    Botswana
                                                 
                                                
                                                    Brazil
                                                 
                                                
                                                    Brunei
                                                 
                                                
                                                    Bulgaria
                                                 
                                                
                                                    Burkina Faso
                                                 
                                                
                                                    Burundi
                                                 
                                                
                                                    Cambodia
                                                 
                                                
                                                    Cameroon
                                                 
                                                
                                                    Canada
                                                 
                                                
                                                    Cape Verde
                                                 
                                                
                                                    Central African Republic
                                                 
                                                
                                                    Chad
                                                 
                                                
                                                    Chile
                                                 
                                                
                                                    China
                                                 
                                                
                                                    Colombia
                                                 
                                                
                                                    Comoros
                                                 
                                                
                                                    Congo-Kinshasa
                                                 
                                                
                                                    Congo-Brazzaville
                                                 
                                                
                                                    Costa Rica
                                                 
                                                
                                                    Cote d Ivoire (Ivory Coast)
                                                 
                                                
                                                    Croatia
                                                 
                                                
                                                    Cuba
                                                 
                                                
                                                    Cyprus
                                                 
                                                
                                                    Czech Republic
                                                 
                                                
                                                    Denmark
                                                 
                                                
                                                    Djibouti
                                                 
                                                
                                                    Dominica
                                                 
                                                
                                                    Dominican Republic
                                                 
                                                
                                                    Ecuador
                                                 
                                                
                                                    Egypt
                                                 
                                                
                                                    El Salvador
                                                 
                                                
                                                    Equatorial Guinea
                                                 
                                                
                                                    Eritrea
                                                 
                                                
                                                    Estonia
                                                 
                                                
                                                    Ethiopia
                                                 
                                                
                                                    Fiji
                                                 
                                                
                                                    Finland
                                                 
                                                
                                                    France
                                                 
                                                
                                                    Gabon
                                                 
                                                
                                                    Gambia
                                                 
                                                
                                                    Georgia
                                                 
                                                
                                                    Germany
                                                 
                                                
                                                    Ghana
                                                 
                                                
                                                    Greece
                                                 
                                                
                                                    Grenada
                                                 
                                                
                                                    Guatemala
                                                 
                                                
                                                    Guinea
                                                 
                                                
                                                    Guinea-Bissau
                                                 
                                                
                                                    Guyana
                                                 
                                                
                                                    Haiti
                                                 
                                                
                                                    Honduras
                                                 
                                                
                                                    Hungary
                                                 
                                                
                                                    Iceland
                                                 
                                                
                                                    India
                                                 
                                                
                                                    Indonesia
                                                 
                                                
                                                    Iran
                                                 
                                                
                                                    Iraq
                                                 
                                                
                                                    Ireland
                                                 
                                                
                                                    Israel
                                                 
                                                
                                                    Italy
                                                 
                                                
                                                    Jamaica
                                                 
                                                
                                                    Japan
                                                 
                                                
                                                    Jordan
                                                 
                                                
                                                    Kazakhstan
                                                 
                                                
                                                    Kenya
                                                 
                                                
                                                    Kiribati
                                                 
                                                
                                                    Korea (North)
                                                 
                                                
                                                    Korea (South)
                                                 
                                                
                                                    Kuwait
                                                 
                                                
                                                    Kyrgyzstan
                                                 
                                                
                                                    Laos
                                                 
                                                
                                                    Latvia
                                                 
                                                
                                                    Lebanon
                                                 
                                                
                                                    Lesotho
                                                 
                                                
                                                    Liberia
                                                 
                                                
                                                    Libya
                                                 
                                                
                                                    Liechtenstein
                                                 
                                                
                                                    Lithuania
                                                 
                                                
                                                    Luxembourg
                                                 
                                                
                                                    Macedonia
                                                 
                                                
                                                    Madagascar
                                                 
                                                
                                                    Malawi
                                                 
                                                
                                                    Malaysia
                                                 
                                                
                                                    Maldives
                                                 
                                                
                                                    Mali
                                                 
                                                
                                                    Malta
                                                 
                                                
                                                    Marshall Islands
                                                 
                                                
                                                    Mauritania
                                                 
                                                
                                                    Mauritius
                                                 
                                                
                                                    Mexico
                                                 
                                                
                                                    Micronesia
                                                 
                                                
                                                    Moldova
                                                 
                                                
                                                    Monaco
                                                 
                                                
                                                    Mongolia
                                                 
                                                
                                                    Montenegro
                                                 
                                                
                                                    Morocco
                                                 
                                                
                                                    Mozambique
                                                 
                                                
                                                    Myanmar (Burma)
                                                 
                                                
                                                    Namibia
                                                 
                                                
                                                    Nauru
                                                 
                                                
                                                    Nepal
                                                 
                                                
                                                    Netherlands
                                                 
                                                
                                                    New Zealand
                                                 
                                                
                                                    Nicaragua
                                                 
                                                
                                                    Niger
                                                 
                                                
                                                    Nigeria
                                                 
                                                
                                                    Norway
                                                 
                                                
                                                    Oman
                                                 
                                                
                                                    Pakistan
                                                 
                                                
                                                    Palau
                                                 
                                                
                                                    Panama
                                                 
                                                
                                                    Papua New Guinea
                                                 
                                                
                                                    Paraguay
                                                 
                                                
                                                    Peru
                                                 
                                                
                                                    Philippines
                                                 
                                                
                                                    Poland
                                                 
                                                
                                                    Portugal
                                                 
                                                
                                                    Qatar
                                                 
                                                
                                                    Romania
                                                 
                                                
                                                    Russia
                                                 
                                                
                                                    Rwanda
                                                 
                                                
                                                    Saint Kitts and Nevis
                                                 
                                                
                                                    Saint Lucia
                                                 
                                                
                                                    Saint Vincent and the Grenadines
                                                 
                                                
                                                    Samoa
                                                 
                                                
                                                    San Marino
                                                 
                                                
                                                    Sao Tome and Principe
                                                 
                                                
                                                    Saudi Arabia
                                                 
                                                
                                                    Senegal
                                                 
                                                
                                                    Serbia
                                                 
                                                
                                                    Seychelles
                                                 
                                                
                                                    Sierra Leone
                                                 
                                                
                                                    Singapore
                                                 
                                                
                                                    Slovakia
                                                 
                                                
                                                    Slovenia
                                                 
                                                
                                                    Solomon Islands
                                                 
                                                
                                                    Somalia
                                                 
                                                
                                                    South Africa
                                                 
                                                
                                                    Spain
                                                 
                                                
                                                    Sri Lanka
                                                 
                                                
                                                    Sudan
                                                 
                                                
                                                    Suriname
                                                 
                                                
                                                    Swaziland
                                                 
                                                
                                                    Sweden
                                                 
                                                
                                                    Switzerland
                                                 
                                                
                                                    Syria
                                                 
                                                
                                                    Tajikistan
                                                 
                                                
                                                    Tanzania
                                                 
                                                
                                                    Thailand
                                                 
                                                
                                                    Timor-Leste (East Timor)
                                                 
                                                
                                                    Togo
                                                 
                                                
                                                    Tonga
                                                 
                                                
                                                    Trinidad and Tobago
                                                 
                                                
                                                    Tunisia
                                                 
                                                
                                                    Turkey
                                                 
                                                
                                                    Turkmenistan
                                                 
                                                
                                                    Tuvalu
                                                 
                                                
                                                    Uganda
                                                 
                                                
                                                    Ukraine
                                                 
                                                
                                                    United Arab Emirates
                                                 
                                                
                                                    United Kingdom
                                                 
                                                
                                                    United States
                                                 
                                                
                                                    Uruguay
                                                 
                                                
                                                    Uzbekistan
                                                 
                                                
                                                    Vanuatu
                                                 
                                                
                                                    Vatican City
                                                 
                                                
                                                    Venezuela
                                                 
                                                
                                                    Viet Nam
                                                 
                                                
                                                    Yemen
                                                 
                                                
                                                    Zambia
                                                 
                                                
                                                    Zimbabwe
                                                 
                                                
                                                    ----------------
                                                 
                                                
                                                    Territories
                                                 
                                                
                                                    -----------------
                                                 
                                                
                                                    Abkhazia
                                                 
                                                
                                                    Taiwan
                                                 
                                                
                                                    Northern Cyprus
                                                 
                                                
                                                    Pridnestrovie (Transnistria)
                                                 
                                                
                                                    Somaliland
                                                 
                                                
                                                    South Ossetia
                                                 
                                                
                                                    Ashmore and Cartier Islands
                                                 
                                                
                                                    Christmas Island
                                                 
                                                
                                                    Cocos (Keeling) Islands
                                                 
                                                
                                                    Coral Sea Islands
                                                 
                                                
                                                    Heard Island and McDonald Islands
                                                 
                                                
                                                    Norfolk Island
                                                 
                                                
                                                    New Caledonia
                                                 
                                                
                                                    French Polynesia
                                                 
                                                
                                                    Mayotte
                                                 
                                                
                                                    Saint Barthelemy
                                                 
                                                
                                                    Saint Martin
                                                 
                                                
                                                    Saint Pierre and Miquelon
                                                 
                                                
                                                    Wallis and Futuna
                                                 
                                                
                                                    French Southern and Antarctic Lands
                                                 
                                                
                                                    Clipperton Island
                                                 
                                                
                                                    Bouvet Island
                                                 
                                                
                                                    Cook Islands
                                                 
                                                
                                                    Niue
                                                 
                                                
                                                    Tokelau
                                                 
                                                
                                                    Guernsey
                                                 
                                                
                                                    Isle of Man
                                                 
                                                
                                                    Jersey
                                                 
                                                
                                                    Anguilla
                                                 
                                                
                                                    Bermuda
                                                 
                                                
                                                    British Indian Ocean Territory
                                                 
                                                
                                                    British Sovereign Base Are
                                                 
                                                
                                                    British Virgin Islands
                                                 
                                                
                                                    Cayman Islands
                                                 
                                                
                                                    Falkland Islands (Islas Malvinas)
                                                 
                                                
                                                    Gibraltar
                                                 
                                                
                                                    Montserrat
                                                 
                                                
                                                    Pitcairn Islands
                                                 
                                                
                                                    Saint Helena
                                                 
                                                
                                                    South Georgia and the South Sandwich Islands
                                                 
                                                
                                                    Turks and Caicos Islands
                                                 
                                                
                                                    Northern Mariana Islands
                                                 
                                                
                                                    Puerto Rico
                                                 
                                                
                                                    American Samoa
                                                 
                                                
                                                    Baker Island
                                                 
                                                
                                                    Guam
                                                 
                                                
                                                    Howland Island
                                                 
                                                
                                                    Jarvis Island
                                                 
                                                
                                                    Johnston Atoll
                                                 
                                                
                                                    Kingman Reef
                                                 
                                                
                                                    Midway Islands
                                                 
                                                
                                                    Navassa Island
                                                 
                                                
                                                    Palmyra Atoll
                                                 
                                                
                                                    U.S. Virgin Islands
                                                 
                                                
                                                    Wake Island
                                                 
                                                
                                                    Hong Kong
                                                 
                                                
                                                    Macau
                                                 
                                                
                                                    Faroe Islands
                                                 
                                                
                                                    Greenland
                                                 
                                                
                                                    French Guiana
                                                 
                                                
                                                    Guadeloupe
                                                 
                                                
                                                    Martinique
                                                 
                                                
                                                    Reunion
                                                 
                                                
                                                    Aland
                                                 
                                                
                                                    Aruba
                                                 
                                                
                                                    Netherlands Antilles
                                                 
                                                
                                                    Svalbard
                                                 
                                                
                                                    Ascension
                                                 
                                                
                                                    Tristan da Cunha
                                                 
                                                
                                                    Antarctica
                                                 
                                                
                                                    Kosovo
                                                 
                                                
                                                    Palestinian Territories - Gaza Strip
                                                 
                                                
                                                    Palestinian Territories - West Bank
                                                 
                                                
                                                    Western Sahara
                                                 
                                                
                                                    Australian Antarctic Territory
                                                 
                                                
                                                    Ross Dependency
                                                 
                                                
                                                    Peter Island
                                                 
                                                
                                                    Queen Maud Land
                                                 
                                                
                                                    British Antarctic Territory
                                                 
                                             
                                       
                                        
                                        
                                        
                                            Date of birth: 
                                        
                                        
                                            
                                        
                                        
                                             Sex  
                                        
                                        
                                            Male  Female  
                                        
                                        
                                            Country and place of birth: 
                                        
                                        
                                            
                                        
                                        
                                            Country of residence: 
                                        
                                        
                                            
                                                
                                                    Afghanistan
                                                 
                                                
                                                    Albania
                                                 
                                                
                                                    Algeria
                                                 
                                                
                                                    Andorra
                                                 
                                                
                                                    Angola
                                                 
                                                
                                                    Antigua and Barbuda
                                                 
                                                
                                                    Argentina
                                                 
                                                
                                                    Armenia
                                                 
                                                
                                                    Australia
                                                 
                                                
                                                    Austria
                                                 
                                                
                                                    Azerbaijan
                                                 
                                                
                                                    Bahamas
                                                 
                                                
                                                    Bahrain
                                                 
                                                
                                                    Bangladesh
                                                 
                                                
                                                    Barbados
                                                 
                                                
                                                    Belarus
                                                 
                                                
                                                    Belgium
                                                 
                                                
                                                    Belize
                                                 
                                                
                                                    Benin
                                                 
                                                
                                                    Bhutan
                                                 
                                                
                                                    Bolivia
                                                 
                                                
                                                    Bosnia and Herzegovina
                                                 
                                                
                                                    Botswana
                                                 
                                                
                                                    Brazil
                                                 
                                                
                                                    Brunei
                                                 
                                                
                                                    Bulgaria
                                                 
                                                
                                                    Burkina Faso
                                                 
                                                
                                                    Burundi
                                                 
                                                
                                                    Cambodia
                                                 
                                                
                                                    Cameroon
                                                 
                                                
                                                    Canada
                                                 
                                                
                                                    Cape Verde
                                                 
                                                
                                                    Central African Republic
                                                 
                                                
                                                    Chad
                                                 
                                                
                                                    Chile
                                                 
                                                
                                                    China
                                                 
                                                
                                                    Colombia
                                                 
                                                
                                                    Comoros
                                                 
                                                
                                                    Congo-Kinshasa
                                                 
                                                
                                                    Congo-Brazzaville
                                                 
                                                
                                                    Costa Rica
                                                 
                                                
                                                    Cote d Ivoire (Ivory Coast)
                                                 
                                                
                                                    Croatia
                                                 
                                                
                                                    Cuba
                                                 
                                                
                                                    Cyprus
                                                 
                                                
                                                    Czech Republic
                                                 
                                                
                                                    Denmark
                                                 
                                                
                                                    Djibouti
                                                 
                                                
                                                    Dominica
                                                 
                                                
                                                    Dominican Republic
                                                 
                                                
                                                    Ecuador
                                                 
                                                
                                                    Egypt
                                                 
                                                
                                                    El Salvador
                                                 
                                                
                                                    Equatorial Guinea
                                                 
                                                
                                                    Eritrea
                                                 
                                                
                                                    Estonia
                                                 
                                                
                                                    Ethiopia
                                                 
                                                
                                                    Fiji
                                                 
                                                
                                                    Finland
                                                 
                                                
                                                    France
                                                 
                                                
                                                    Gabon
                                                 
                                                
                                                    Gambia
                                                 
                                                
                                                    Georgia
                                                 
                                                
                                                    Germany
                                                 
                                                
                                                    Ghana
                                                 
                                                
                                                    Greece
                                                 
                                                
                                                    Grenada
                                                 
                                                
                                                    Guatemala
                                                 
                                                
                                                    Guinea
                                                 
                                                
                                                    Guinea-Bissau
                                                 
                                                
                                                    Guyana
                                                 
                                                
                                                    Haiti
                                                 
                                                
                                                    Honduras
                                                 
                                                
                                                    Hungary
                                                 
                                                
                                                    Iceland
                                                 
                                                
                                                    India
                                                 
                                                
                                                    Indonesia
                                                 
                                                
                                                    Iran
                                                 
                                                
                                                    Iraq
                                                 
                                                
                                                    Ireland
                                                 
                                                
                                                    Israel
                                                 
                                                
                                                    Italy
                                                 
                                                
                                                    Jamaica
                                                 
                                                
                                                    Japan
                                                 
                                                
                                                    Jordan
                                                 
                                                
                                                    Kazakhstan
                                                 
                                                
                                                    Kenya
                                                 
                                                
                                                    Kiribati
                                                 
                                                
                                                    Korea (North)
                                                 
                                                
                                                    Korea (South)
                                                 
                                                
                                                    Kuwait
                                                 
                                                
                                                    Kyrgyzstan
                                                 
                                                
                                                    Laos
                                                 
                                                
                                                    Latvia
                                                 
                                                
                                                    Lebanon
                                                 
                                                
                                                    Lesotho
                                                 
                                                
                                                    Liberia
                                                 
                                                
                                                    Libya
                                                 
                                                
                                                    Liechtenstein
                                                 
                                                
                                                    Lithuania
                                                 
                                                
                                                    Luxembourg
                                                 
                                                
                                                    Macedonia
                                                 
                                                
                                                    Madagascar
                                                 
                                                
                                                    Malawi
                                                 
                                                
                                                    Malaysia
                                                 
                                                
                                                    Maldives
                                                 
                                                
                                                    Mali
                                                 
                                                
                                                    Malta
                                                 
                                                
                                                    Marshall Islands
                                                 
                                                
                                                    Mauritania
                                                 
                                                
                                                    Mauritius
                                                 
                                                
                                                    Mexico
                                                 
                                                
                                                    Micronesia
                                                 
                                                
                                                    Moldova
                                                 
                                                
                                                    Monaco
                                                 
                                                
                                                    Mongolia
                                                 
                                                
                                                    Montenegro
                                                 
                                                
                                                    Morocco
                                                 
                                                
                                                    Mozambique
                                                 
                                                
                                                    Myanmar (Burma)
                                                 
                                                
                                                    Namibia
                                                 
                                                
                                                    Nauru
                                                 
                                                
                                                    Nepal
                                                 
                                                
                                                    Netherlands
                                                 
                                                
                                                    New Zealand
                                                 
                                                
                                                    Nicaragua
                                                 
                                                
                                                    Niger
                                                 
                                                
                                                    Nigeria
                                                 
                                                
                                                    Norway
                                                 
                                                
                                                    Oman
                                                 
                                                
                                                    Pakistan
                                                 
                                                
                                                    Palau
                                                 
                                                
                                                    Panama
                                                 
                                                
                                                    Papua New Guinea
                                                 
                                                
                                                    Paraguay
                                                 
                                                
                                                    Peru
                                                 
                                                
                                                    Philippines
                                                 
                                                
                                                    Poland
                                                 
                                                
                                                    Portugal
                                                 
                                                
                                                    Qatar
                                                 
                                                
                                                    Romania
                                                 
                                                
                                                    Russia
                                                 
                                                
                                                    Rwanda
                                                 
                                                
                                                    Saint Kitts and Nevis
                                                 
                                                
                                                    Saint Lucia
                                                 
                                                
                                                    Saint Vincent and the Grenadines
                                                 
                                                
                                                    Samoa
                                                 
                                                
                                                    San Marino
                                                 
                                                
                                                    Sao Tome and Principe
                                                 
                                                
                                                    Saudi Arabia
                                                 
                                                
                                                    Senegal
                                                 
                                                
                                                    Serbia
                                                 
                                                
                                                    Seychelles
                                                 
                                                
                                                    Sierra Leone
                                                 
                                                
                                                    Singapore
                                                 
                                                
                                                    Slovakia
                                                 
                                                
                                                    Slovenia
                                                 
                                                
                                                    Solomon Islands
                                                 
                                                
                                                    Somalia
                                                 
                                                
                                                    South Africa
                                                 
                                                
                                                    Spain
                                                 
                                                
                                                    Sri Lanka
                                                 
                                                
                                                    Sudan
                                                 
                                                
                                                    Suriname
                                                 
                                                
                                                    Swaziland
                                                 
                                                
                                                    Sweden
                                                 
                                                
                                                    Switzerland
                                                 
                                                
                                                    Syria
                                                 
                                                
                                                    Tajikistan
                                                 
                                                
                                                    Tanzania
                                                 
                                                
                                                    Thailand
                                                 
                                                
                                                    Timor-Leste (East Timor)
                                                 
                                                
                                                    Togo
                                                 
                                                
                                                    Tonga
                                                 
                                                
                                                    Trinidad and Tobago
                                                 
                                                
                                                    Tunisia
                                                 
                                                
                                                    Turkey
                                                 
                                                
                                                    Turkmenistan
                                                 
                                                
                                                    Tuvalu
                                                 
                                                
                                                    Uganda
                                                 
                                                
                                                    Ukraine
                                                 
                                                
                                                    United Arab Emirates
                                                 
                                                
                                                    United Kingdom
                                                 
                                                
                                                    United States
                                                 
                                                
                                                    Uruguay
                                                 
                                                
                                                    Uzbekistan
                                                 
                                                
                                                    Vanuatu
                                                 
                                                
                                                    Vatican City
                                                 
                                                
                                                    Venezuela
                                                 
                                                
                                                    Viet Nam
                                                 
                                                
                                                    Yemen
                                                 
                                                
                                                    Zambia
                                                 
                                                
                                                    Zimbabwe
                                                 
                                                
                                                    ----------------
                                                 
                                                
                                                    Territories
                                                 
                                                
                                                    -----------------
                                                 
                                                
                                                    Abkhazia
                                                 
                                                
                                                    Taiwan
                                                 
                                                
                                                    Northern Cyprus
                                                 
                                                
                                                    Pridnestrovie (Transnistria)
                                                 
                                                
                                                    Somaliland
                                                 
                                                
                                                    South Ossetia
                                                 
                                                
                                                    Ashmore and Cartier Islands
                                                 
                                                
                                                    Christmas Island
                                                 
                                                
                                                    Cocos (Keeling) Islands
                                                 
                                                
                                                    Coral Sea Islands
                                                 
                                                
                                                    Heard Island and McDonald Islands
                                                 
                                                
                                                    Norfolk Island
                                                 
                                                
                                                    New Caledonia
                                                 
                                                
                                                    French Polynesia
                                                 
                                                
                                                    Mayotte
                                                 
                                                
                                                    Saint Barthelemy
                                                 
                                                
                                                    Saint Martin
                                                 
                                                
                                                    Saint Pierre and Miquelon
                                                 
                                                
                                                    Wallis and Futuna
                                                 
                                                
                                                    French Southern and Antarctic Lands
                                                 
                                                
                                                    Clipperton Island
                                                 
                                                
                                                    Bouvet Island
                                                 
                                                
                                                    Cook Islands
                                                 
                                                
                                                    Niue
                                                 
                                                
                                                    Tokelau
                                                 
                                                
                                                    Guernsey
                                                 
                                                
                                                    Isle of Man
                                                 
                                                
                                                    Jersey
                                                 
                                                
                                                    Anguilla
                                                 
                                                
                                                    Bermuda
                                                 
                                                
                                                    British Indian Ocean Territory
                                                 
                                                
                                                    British Sovereign Base Are
                                                 
                                                
                                                    British Virgin Islands
                                                 
                                                
                                                    Cayman Islands
                                                 
                                                
                                                    Falkland Islands (Islas Malvinas)
                                                 
                                                
                                                    Gibraltar
                                                 
                                                
                                                    Montserrat
                                                 
                                                
                                                    Pitcairn Islands
                                                 
                                                
                                                    Saint Helena
                                                 
                                                
                                                    South Georgia and the South Sandwich Islands
                                                 
                                                
                                                    Turks and Caicos Islands
                                                 
                                                
                                                    Northern Mariana Islands
                                                 
                                                
                                                    Puerto Rico
                                                 
                                                
                                                    American Samoa
                                                 
                                                
                                                    Baker Island
                                                 
                                                
                                                    Guam
                                                 
                                                
                                                    Howland Island
                                                 
                                                
                                                    Jarvis Island
                                                 
                                                
                                                    Johnston Atoll
                                                 
                                                
                                                    Kingman Reef
                                                 
                                                
                                                    Midway Islands
                                                 
                                                
                                                    Navassa Island
                                                 
                                                
                                                    Palmyra Atoll
                                                 
                                                
                                                    U.S. Virgin Islands
                                                 
                                                
                                                    Wake Island
                                                 
                                                
                                                    Hong Kong
                                                 
                                                
                                                    Macau
                                                 
                                                
                                                    Faroe Islands
                                                 
                                                
                                                    Greenland
                                                 
                                                
                                                    French Guiana
                                                 
                                                
                                                    Guadeloupe
                                                 
                                                
                                                    Martinique
                                                 
                                                
                                                    Reunion
                                                 
                                                
                                                    Aland
                                                 
                                                
                                                    Aruba
                                                 
                                                
                                                    Netherlands Antilles
                                                 
                                                
                                                    Svalbard
                                                 
                                                
                                                    Ascension
                                                 
                                                
                                                    Tristan da Cunha
                                                 
                                                
                                                    Antarctica
                                                 
                                                
                                                    Kosovo
                                                 
                                                
                                                    Palestinian Territories - Gaza Strip
                                                 
                                                
                                                    Palestinian Territories - West Bank
                                                 
                                                
                                                    Western Sahara
                                                 
                                                
                                                    Australian Antarctic Territory
                                                 
                                                
                                                    Ross Dependency
                                                 
                                                
                                                    Peter Island
                                                 
                                                
                                                    Queen Maud Land
                                                 
                                                
                                                    British Antarctic Territory
                                                 
                                             
                                         
                                        
                                        
                                        
                                             Marital status   
                                        
                                        
                                            Single  Married  Divorced  
                                        
                                        
                                            Number of dependents under the age of 11: 
                                        
                                        
                                            
                                        
                                        
                                            Number of dependents between 12 and 17 years old: 
                                        
                                        
                                            
                                        
                                        
                                            Number of dependents between 18 and 24 years old: 
                                        
                                        
                                            
                                        
                                        
                                            The country you are interested in: 
                                        
                                        
                                            
                                                
                                                    Cyprus    
                                                 
                                                
                                                    Greece   
                                                 
                                                
                                                    Portugal 
                                                 
                                                
                                                    Hungary 
                                                 
                                                
                                                    Bulgaria 
                                                 
                                                
                                                    USA 
                                                 
                                                
                                                    Malta 
                                                 
                                                
                                                    Dominica 
                                                 
                                                
                                                    Grenada 
                                                 
                                                
                                                    Antigua and Barbuda
                                                 
                                                
                                                    St. Kitts and Nevis 
                                                 
                                              
                                        
                                        
                                        
                                            Last country of residence: 
                                        
                                        
                                            
                                                
                                                    Afghanistan
                                                 
                                                
                                                    Albania
                                                 
                                                
                                                    Algeria
                                                 
                                                
                                                    Andorra
                                                 
                                                
                                                    Angola
                                                 
                                                
                                                    Antigua and Barbuda
                                                 
                                                
                                                    Argentina
                                                 
                                                
                                                    Armenia
                                                 
                                                
                                                    Australia
                                                 
                                                
                                                    Austria
                                                 
                                                
                                                    Azerbaijan
                                                 
                                                
                                                    Bahamas
                                                 
                                                
                                                    Bahrain
                                                 
                                                
                                                    Bangladesh
                                                 
                                                
                                                    Barbados
                                                 
                                                
                                                    Belarus
                                                 
                                                
                                                    Belgium
                                                 
                                                
                                                    Belize
                                                 
                                                
                                                    Benin
                                                 
                                                
                                                    Bhutan
                                                 
                                                
                                                    Bolivia
                                                 
                                                
                                                    Bosnia and Herzegovina
                                                 
                                                
                                                    Botswana
                                                 
                                                
                                                    Brazil
                                                 
                                                
                                                    Brunei
                                                 
                                                
                                                    Bulgaria
                                                 
                                                
                                                    Burkina Faso
                                                 
                                                
                                                    Burundi
                                                 
                                                
                                                    Cambodia
                                                 
                                                
                                                    Cameroon
                                                 
                                                
                                                    Canada
                                                 
                                                
                                                    Cape Verde
                                                 
                                                
                                                    Central African Republic
                                                 
                                                
                                                    Chad
                                                 
                                                
                                                    Chile
                                                 
                                                
                                                    China
                                                 
                                                
                                                    Colombia
                                                 
                                                
                                                    Comoros
                                                 
                                                
                                                    Congo-Kinshasa
                                                 
                                                
                                                    Congo-Brazzaville
                                                 
                                                
                                                    Costa Rica
                                                 
                                                
                                                    Cote d Ivoire (Ivory Coast)
                                                 
                                                
                                                    Croatia
                                                 
                                                
                                                    Cuba
                                                 
                                                
                                                    Cyprus
                                                 
                                                
                                                    Czech Republic
                                                 
                                                
                                                    Denmark
                                                 
                                                
                                                    Djibouti
                                                 
                                                
                                                    Dominica
                                                 
                                                
                                                    Dominican Republic
                                                 
                                                
                                                    Ecuador
                                                 
                                                
                                                    Egypt
                                                 
                                                
                                                    El Salvador
                                                 
                                                
                                                    Equatorial Guinea
                                                 
                                                
                                                    Eritrea
                                                 
                                                
                                                    Estonia
                                                 
                                                
                                                    Ethiopia
                                                 
                                                
                                                    Fiji
                                                 
                                                
                                                    Finland
                                                 
                                                
                                                    France
                                                 
                                                
                                                    Gabon
                                                 
                                                
                                                    Gambia
                                                 
                                                
                                                    Georgia
                                                 
                                                
                                                    Germany
                                                 
                                                
                                                    Ghana
                                                 
                                                
                                                    Greece
                                                 
                                                
                                                    Grenada
                                                 
                                                
                                                    Guatemala
                                                 
                                                
                                                    Guinea
                                                 
                                                
                                                    Guinea-Bissau
                                                 
                                                
                                                    Guyana
                                                 
                                                
                                                    Haiti
                                                 
                                                
                                                    Honduras
                                                 
                                                
                                                    Hungary
                                                 
                                                
                                                    Iceland
                                                 
                                                
                                                    India
                                                 
                                                
                                                    Indonesia
                                                 
                                                
                                                    Iran
                                                 
                                                
                                                    Iraq
                                                 
                                                
                                                    Ireland
                                                 
                                                
                                                    Israel
                                                 
                                                
                                                    Italy
                                                 
                                                
                                                    Jamaica
                                                 
                                                
                                                    Japan
                                                 
                                                
                                                    Jordan
                                                 
                                                
                                                    Kazakhstan
                                                 
                                                
                                                    Kenya
                                                 
                                                
                                                    Kiribati
                                                 
                                                
                                                    Korea (North)
                                                 
                                                
                                                    Korea (South)
                                                 
                                                
                                                    Kuwait
                                                 
                                                
                                                    Kyrgyzstan
                                                 
                                                
                                                    Laos
                                                 
                                                
                                                    Latvia
                                                 
                                                
                                                    Lebanon
                                                 
                                                
                                                    Lesotho
                                                 
                                                
                                                    Liberia
                                                 
                                                
                                                    Libya
                                                 
                                                
                                                    Liechtenstein
                                                 
                                                
                                                    Lithuania
                                                 
                                                
                                                    Luxembourg
                                                 
                                                
                                                    Macedonia
                                                 
                                                
                                                    Madagascar
                                                 
                                                
                                                    Malawi
                                                 
                                                
                                                    Malaysia
                                                 
                                                
                                                    Maldives
                                                 
                                                
                                                    Mali
                                                 
                                                
                                                    Malta
                                                 
                                                
                                                    Marshall Islands
                                                 
                                                
                                                    Mauritania
                                                 
                                                
                                                    Mauritius
                                                 
                                                
                                                    Mexico
                                                 
                                                
                                                    Micronesia
                                                 
                                                
                                                    Moldova
                                                 
                                                
                                                    Monaco
                                                 
                                                
                                                    Mongolia
                                                 
                                                
                                                    Montenegro
                                                 
                                                
                                                    Morocco
                                                 
                                                
                                                    Mozambique
                                                 
                                                
                                                    Myanmar (Burma)
                                                 
                                                
                                                    Namibia
                                                 
                                                
                                                    Nauru
                                                 
                                                
                                                    Nepal
                                                 
                                                
                                                    Netherlands
                                                 
                                                
                                                    New Zealand
                                                 
                                                
                                                    Nicaragua
                                                 
                                                
                                                    Niger
                                                 
                                                
                                                    Nigeria
                                                 
                                                
                                                    Norway
                                                 
                                                
                                                    Oman
                                                 
                                                
                                                    Pakistan
                                                 
                                                
                                                    Palau
                                                 
                                                
                                                    Panama
                                                 
                                                
                                                    Papua New Guinea
                                                 
                                                
                                                    Paraguay
                                                 
                                                
                                                    Peru
                                                 
                                                
                                                    Philippines
                                                 
                                                
                                                    Poland
                                                 
                                                
                                                    Portugal
                                                 
                                                
                                                    Qatar
                                                 
                                                
                                                    Romania
                                                 
                                                
                                                    Russia
                                                 
                                                
                                                    Rwanda
                                                 
                                                
                                                    Saint Kitts and Nevis
                                                 
                                                
                                                    Saint Lucia
                                                 
                                                
                                                    Saint Vincent and the Grenadines
                                                 
                                                
                                                    Samoa
                                                 
                                                
                                                    San Marino
                                                 
                                                
                                                    Sao Tome and Principe
                                                 
                                                
                                                    Saudi Arabia
                                                 
                                                
                                                    Senegal
                                                 
                                                
                                                    Serbia
                                                 
                                                
                                                    Seychelles
                                                 
                                                
                                                    Sierra Leone
                                                 
                                                
                                                    Singapore
                                                 
                                                
                                                    Slovakia
                                                 
                                                
                                                    Slovenia
                                                 
                                                
                                                    Solomon Islands
                                                 
                                                
                                                    Somalia
                                                 
                                                
                                                    South Africa
                                                 
                                                
                                                    Spain
                                                 
                                                
                                                    Sri Lanka
                                                 
                                                
                                                    Sudan
                                                 
                                                
                                                    Suriname
                                                 
                                                
                                                    Swaziland
                                                 
                                                
                                                    Sweden
                                                 
                                                
                                                    Switzerland
                                                 
                                                
                                                    Syria
                                                 
                                                
                                                    Tajikistan
                                                 
                                                
                                                    Tanzania
                                                 
                                                
                                                    Thailand
                                                 
                                                
                                                    Timor-Leste (East Timor)
                                                 
                                                
                                                    Togo
                                                 
                                                
                                                    Tonga
                                                 
                                                
                                                    Trinidad and Tobago
                                                 
                                                
                                                    Tunisia
                                                 
                                                
                                                    Turkey
                                                 
                                                
                                                    Turkmenistan
                                                 
                                                
                                                    Tuvalu
                                                 
                                                
                                                    Uganda
                                                 
                                                
                                                    Ukraine
                                                 
                                                
                                                    United Arab Emirates
                                                 
                                                
                                                    United Kingdom
                                                 
                                                
                                                    United States
                                                 
                                                
                                                    Uruguay
                                                 
                                                
                                                    Uzbekistan
                                                 
                                                
                                                    Vanuatu
                                                 
                                                
                                                    Vatican City
                                                 
                                                
                                                    Venezuela
                                                 
                                                
                                                    Viet Nam
                                                 
                                                
                                                    Yemen
                                                 
                                                
                                                    Zambia
                                                 
                                                
                                                    Zimbabwe
                                                 
                                                
                                                    ----------------
                                                 
                                                
                                                    Territories
                                                 
                                                
                                                    -----------------
                                                 
                                                
                                                    Abkhazia
                                                 
                                                
                                                    Taiwan
                                                 
                                                
                                                    Northern Cyprus
                                                 
                                                
                                                    Pridnestrovie (Transnistria)
                                                 
                                                
                                                    Somaliland
                                                 
                                                
                                                    South Ossetia
                                                 
                                                
                                                    Ashmore and Cartier Islands
                                                 
                                                
                                                    Christmas Island
                                                 
                                                
                                                    Cocos (Keeling) Islands
                                                 
                                                
                                                    Coral Sea Islands
                                                 
                                                
                                                    Heard Island and McDonald Islands
                                                 
                                                
                                                    Norfolk Island
                                                 
                                                
                                                    New Caledonia
                                                 
                                                
                                                    French Polynesia
                                                 
                                                
                                                    Mayotte
                                                 
                                                
                                                    Saint Barthelemy
                                                 
                                                
                                                    Saint Martin
                                                 
                                                
                                                    Saint Pierre and Miquelon
                                                 
                                                
                                                    Wallis and Futuna
                                                 
                                                
                                                    French Southern and Antarctic Lands
                                                 
                                                
                                                    Clipperton Island
                                                 
                                                
                                                    Bouvet Island
                                                 
                                                
                                                    Cook Islands
                                                 
                                                
                                                    Niue
                                                 
                                                
                                                    Tokelau
                                                 
                                                
                                                    Guernsey
                                                 
                                                
                                                    Isle of Man
                                                 
                                                
                                                    Jersey
                                                 
                                                
                                                    Anguilla
                                                 
                                                
                                                    Bermuda
                                                 
                                                
                                                    British Indian Ocean Territory
                                                 
                                                
                                                    British Sovereign Base Are
                                                 
                                                
                                                    British Virgin Islands
                                                 
                                                
                                                    Cayman Islands
                                                 
                                                
                                                    Falkland Islands (Islas Malvinas)
                                                 
                                                
                                                    Gibraltar
                                                 
                                                
                                                    Montserrat
                                                 
                                                
                                                    Pitcairn Islands
                                                 
                                                
                                                    Saint Helena
                                                 
                                                
                                                    South Georgia and the South Sandwich Islands
                                                 
                                                
                                                    Turks and Caicos Islands
                                                 
                                                
                                                    Northern Mariana Islands
                                                 
                                                
                                                    Puerto Rico
                                                 
                                                
                                                    American Samoa
                                                 
                                                
                                                    Baker Island
                                                 
                                                
                                                    Guam
                                                 
                                                
                                                    Howland Island
                                                 
                                                
                                                    Jarvis Island
                                                 
                                                
                                                    Johnston Atoll
                                                 
                                                
                                                    Kingman Reef
                                                 
                                                
                                                    Midway Islands
                                                 
                                                
                                                    Navassa Island
                                                 
                                                
                                                    Palmyra Atoll
                                                 
                                                
                                                    U.S. Virgin Islands
                                                 
                                                
                                                    Wake Island
                                                 
                                                
                                                    Hong Kong
                                                 
                                                
                                                    Macau
                                                 
                                                
                                                    Faroe Islands
                                                 
                                                
                                                    Greenland
                                                 
                                                
                                                    French Guiana
                                                 
                                                
                                                    Guadeloupe
                                                 
                                                
                                                    Martinique
                                                 
                                                
                                                    Reunion
                                                 
                                                
                                                    Aland
                                                 
                                                
                                                    Aruba
                                                 
                                                
                                                    Netherlands Antilles
                                                 
                                                
                                                    Svalbard
                                                 
                                                
                                                    Ascension
                                                 
                                                
                                                    Tristan da Cunha
                                                 
                                                
                                                    Antarctica
                                                 
                                                
                                                    Kosovo
                                                 
                                                
                                                    Palestinian Territories - Gaza Strip
                                                 
                                                
                                                    Palestinian Territories - West Bank
                                                 
                                                
                                                    Western Sahara
                                                 
                                                
                                                    Australian Antarctic Territory
                                                 
                                                
                                                    Ross Dependency
                                                 
                                                
                                                    Peter Island
                                                 
                                                
                                                    Queen Maud Land
                                                 
                                                
                                                    British Antarctic Territory
                                                 
                                             
                                        
                                        
                                        
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                                            Annual Income: 
                                        
                                        
                                            
                                        
                                        
                                            Net Asset Value: 
                                        
                                        
                                            
                                        
                                        
                                             Do you have access to additional funds from family members   
                                        
                                        
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