Companies / Businesses Form
for Membership in the Libertocracy Association

  1. What is the name and address of your Firm:
    Name   
    Street    
    City        State/ProvinceCountry
    Zip Code
  2. Is your Firm ? Proprietorship Partnership Cooperative Corporation
  3. Firm's E-mail     
    Firm's Telephone
    Firm's FAX       
  4. WorldWideWeb Address
  5. What is the Business of your Firm:
    Advertising
    Investment
    Education
    Security
    Legal Services
    High Tech
    Software
    Marketing / Sales
    Manufacturing
    Media - Publishing, Entertainment
    Retail
    Services - please explain below
    Other - please explain below

   7. Please enter a brief statement about your Company / Business

8. Is your company currently contracted to do buisness with any political-state?
9. In what capacity do you work with the state? 
10. Are who willing to get contract insurance? 
11. Are you willing to fully comply with the law of your chosen Libercratic government and abide by all regulations and responsibilities? 
12. Is your company/business prepared serve the Libertocracy Association and follow its leadership.

13. Your Name                
14. Your title with the firm
15. Your E-mail                 

Do you wish to become an individual member of the Libertocracy Association, the Human Liberation Alliance or a Libercratic civilzen? If you do, please complete and submit this form and then fill out the Individual membership form.

Thank you for your interest in joining our organization we look forward to a mutually beneficial relationship.

Joining the Human Liberation Alliance is a commitment to work for the organization.
Members agree to volunteer in some capacity, as suits one's abilities, time and preferences, to serve the organization and follow the leadership of the Alliance.

There is no charge for becoming a member of the Human Liberation Alliance.

Membership includes the monthly Libertocracy Association Newsletter with periodic updates, you can unsubscribe to the newsletter later if you want.

All information you give on this form, and in future communications, is kept completely confidential. It will be kept on record by the Libertocracy Association who will never under any circumstances allow this information to be given or sold to other parties, nor will it be voluntarily divulged to any state or its agents. The Libertocracy Association will take all reasonable security measures to insure that any information you give to us will be protected.