Union States Assembly Questionnaire

Now with that stated, WE, the official members of “Union States Assembly” in support of the de jure “The United States of America” welcome you to join us.

Notes:

1) Please only fill this page out once.

2) SINCERE INQUIRIES ONLY PLEASE.

Disclaimers:

1) By agreeing to giving personal contact information you also agree to be contacted by Union States Assembly or the members, via the following: phone, email, and mail.

2) Falsification of personal information is grounds for dismissal from Union States Assembly.

3) Union States Assembly is seeking people ONLY from the geographic land mass generally referred to as America.

Notice: By clicking the "Submit" button, you will automatically receive an email from Union States Assembly alerting you to the scheduled set of informational phone calls, along with the pass code.

Given Name *
Family Name *
Email Address *
Confirm Address *
Telephone Number *
State of the Union or territory *
What do you feel would be your best talent to contribute to this continued endeavor of re-building the de jure "The United States of America" back to full freedom? * Any additional Comments: