Application Form

Your information will not be shared with anyone outside of Societas Via Romana.

If you encounter any problems while filling out this application form, contact the Curatores here.

* indicates a required field

 BASIC INFORMATION

  1. First name: *


  2. Last name: *


  3. Email address: *


    Instant Messenger & Personal Identifier:


  4. Street Address: *


  5. City: *


  6. Region (Province or State) & Country: *


  7. Date of Birth (e.g. 15/06/1960): *
 RELIGIO
  1. If you are an adherent of the Religio Romana, or otherwise a religion from the classical era : which gods do you consider your patron gods?

 CHOOSING A ROMAN NAME (For more information on Roman names click here.)
  1. Choose a Gender: *
    Female Male

  2. Choose a Praenomen (first name): *


  3. Choose a Nomen (family name): *


    Choose a Cognomen (nickname):
           

  4. Press Generate: *


    Press Romanize (optional):


    Your Roman name is:
 LEGAL OBSTACLES

  1. I affirm that there is no legal obstacle to my becoming a member of the Societas Via Romana. *

    Yes

     

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