Full Name (as registered at Paralake Town Hall):
We need your legal identity. No aliases. No masks.

City Phone Number for Contact:
This is how we reach you. Make sure it’s active and secure.

Your Motivation to Join the Uprising:
Tell us why you fight. Rage, justice, loyalty. Your truth matters!

Preferred Role in the Resistance:
Infantry, logistics, intelligence, medic, cookies-baker, gardener... where do you belong? Select your preferred role in the cause Infantry Guerrilla Logistics Expert Intelligence Gatherer Combat Medic Cookies Baker Urban Gardener Pioneer / Demolitionist Undercover Operative Public Relations Officer Field Technician Crisis Response Specialist

Skills or Experience::
Combat training, tech expertise, medical knowledge, simply anything that strengthens the cause.

Special Code (if received):
If a recruiter gave you a code, enter it here. If not, leave blank.