Personal information Nationality (Who has issued/will issue your passport?): Please select Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island (Bouvetoya) Brazil British Indian Ocean Territory (Chagos Archipelago) British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kosovo Kuwait Kyrgyz Republic Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russian Federation Rwanda Réunion Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard & Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom of Great Britain & Northern Ireland United States Minor Outlying Islands United States of America United States Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Closest international airport: Native language(s): Date of birth:
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Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 1899 1898 1897 1896 1895 1894 1893 1892 1891 1890 1889 Gender: Please select Male Female Other Prefer not to say If Other please specify: Occupation (if professional): Field of study (if student): Participation in the Wikimedia projects Username on your primary Wikimedia project (Note: Omit the 'User:' prefix before your username, e.g. User:PQR123 should enter PQR123 only. Please do not include anything before or after your username): (If applicable) Other Wikimedia usernames used for editing: Most active Wikimedia project: Please select Wikipedia Wiktionary Wikimedia Commons Wikibooks Wikisource Wikidata Wikiversity Wikiquote Wikispecies Wikinews Wikivoyage Meta Outreach Incubator Toolforge MediaWiki Second most active Wikimedia project (if applicable): Please select Wikipedia Wiktionary Wikimedia Commons Wikibooks Wikisource Wikidata Wikiversity Wikiquote Wikispecies Wikinews Wikivoyage Meta Outreach Incubator Toolforge MediaWiki Primary language community on wiki: Please select all of the following that describe how you have engaged in the Wikimedia movement.
Active contributor to a Wikimedia project (e.g. Wikipedia, Commons, Wikisource, Wikidata)
Mediawiki code contributor, gadget or other tool-builder for Wikimedia projects
Involvement in some form of Wikimedia organization (Chapters, Thematic Organizations, User Groups)
Wikimedia CheckUser, Admin, Bureaucrat, Steward, and/or OTRS (current or former)
Wikimedia Foundation Grantee
Participant in a Wikimedia program (e.g. GLAM partnerships, Education program, etc.)
Participant in Wikimedia organized events (e.g. photographer contributing to Wiki Loves Monuments, workshop attendee)
Organizer of Wikimedia events (e.g. WLM, edit-a-thons)
None of the above
If yes, please identify the Wikimedia organization and whether you are full or part-time: If yes, please identify the Wikimedia organization here: Tell us about your recent involvement in your home wiki or the broader Wikimedia movement. What have you built or contributed to in order to improve your wiki or community? Have you led or organized any of these activities? Please indicate which of these activities took place in the last 12 months. What’s something great that happened as a result of these activities? This could be described either quantitatively or qualitatively, and could impact either online or offline. Here are some examples that might help. What collaborations with other Wikimedians or Wikimedia organizations are you most proud of? How do you usually share your experiences (or things you’ve learned) with your community? Examples of on-wiki summaries/reports, blog posts, meetup talks, etc. are welcome here. Privacy
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