Participant’s User, Residence & Shipping Information :
Important Note: Please provide complete and accurate information. Your official Participation Claim Certificate and upgrades copy of the capsule kit will be mailed to you using this shipping address. Your name and origin that are printed on the official Profile and Participant ID Cards in the capsule kit also rely on the accuracy of this information.
First Name :
Middle Name or Initial :
Last Name :
Street Address :
Unit or Suite Number :
City of Residence:
State or Province:
Other
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Nunavut
Country of Residence :
United States
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 Herzegowina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Cote D'Ivoire
Croatia (Local Name: Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic Of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People'S Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia, Federated States Of
Moldova, Republic Of
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norfolk Island
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts And Nevis
Saint Lucia
Saint Vincent And The Grenadines
Samoa
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And The South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Tajikistan
Tanzania, United Republic Of
Thailand
Togo
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
United Arab Emirates
Uganda
Ukraine
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Yemen
Yugoslavia
Zambia
Zimbabwe
Not in list
American Samoa
Anguilla
Antarctica
Aruba
Bermuda
Bouvet Island
British Indian Ocean Territory
Cayman Islands
Christmas Island
Cocos (Keeling) Islands
Cook Islands
East Timor
Falkland Islands (Malvinas)
Faroe Islands
France, Metropolitan
French Guiana
French Polynesia
Gibraltar
Greenland
Guadeloupe
Guam
Heard And Mc Donald Islands
Holy See (Vatican City State)
Hong Kong
Korea, Democratic People's Republic Of
Korea, Republic Of
Macau
Macedonia, The Former Yugoslav Republic Of
Martinique
Mayotte
Monaco
Montserrat
Netherlands Antilles
New Caledonia
Niue
Northern Mariana Islands
Pitcairn
Puerto Rico
Singapore
St. Helena
St. Pierre And Miquelon
Svalbard And Jan Mayen Islands
Taiwan, Republic Of China
Tokelau
Turks And Caicos Islands
United States Minor Outlying Islands
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis And Futuna Islands
Western Sahara
Zaire
Postal/ZIP Code:
Date of Birth [mm/dd/yyy] :
Particpant's Gender :
Male
Female
Set Your Username, Email Address, Password & Language : SEE Privacy Policy
Note: Please provide complete and accurate information. Our system requires an accurate EMAIL Address to be used for the account Username. This email address is used to send your reminders and project updates. It is also used to send your account activation notice, and is required if you should ever forget your LOGIN Password. Be sure to keep your email updated and accurate in your user profile and master account records. If you change your email address and do not update the file record you may have to start your account over in the event you loose your password. Your email address is not share or used for any other purpose.
SET Username / Email Address :
SET [CaSe SeNSitiVe] Password :
Please CONFIRM Password :
Weekly
Every 2 Weeks
Monthly
Never Send
English
Spanish
Arabic
Chinese
Dutch
French
German
Greek
Italian
Japanese
Korean
Portugese
Russian
Help Build the WORLD'S LARGEST TIME CAPSULE : Cast Your Memorial Theme Vote
Note: In addition to your participation we ask that you please SHARE THE PROJECT WITH FAMILY & FRIENDS . As a not-for-profit formation, the Foundation is relying on project participants to be as helpful as possible in spreading the word. Additionally, we are restricted in the funding we have available for marketing and advertising. Thus, by sharing the information below you will help us to know how to best invest the limited funds we have available. ~ Thank You !
How did you hear about TCL ?
Facebook
Radio
Crowhouse
Google or Yahoo
From A Friend
Print Media, Brochure, Magazine ...
Television
Other - See Below
Other Source :
Great Mayan Pyramids ~ El Castilla
Great Eygtian Pyramids ~ Giza Plateau
Other Comments or Suggestions :
Please share ideas about any subject,
including suggestions you may have
about the Memorial Theme or how to
improve your participation experience.