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Rogue Nation Citizenship Application

If you would like to apply for citizenship to Rogue Nation, please contact the Citizenship Department at the address below for a citizenship application...
or...print this page, fill in the ALL the blanks, and mail it back to Rogue with your passport-size photo (this is mandatory...no photo, no citizenship card!)
Name:
Mailing Address:
Town/State:
Zip/Country:
Birth Date:
Phone:
Favorite Rogue:
Favorite Restaurant:
Favorite Store to buy Rogue:
___ Yes, add me to the 100% Pure Rogue mailing list (the official organ of The Rogue Nation, available on-line and mailed to our members gratis!)
___ Yes, add me to the Rogue Ales email newsletter (international broadcast)
Add me to the Rogue Pub email lists for local news/events (please select)
__ All, or __ Newport __ Portland __ Eugene __ Isssaquah __ SanFran
comments:
Our mailing list and email list are permission based--we don't barter, sell or share our lists--you can opt out at any time.
Thank you in advance for your interest in becoming a member of Rogue Nation.
Rogue Nation
Citizenship Department
2320 OSU Drive
Newport, OR 97365
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