First name*:
Last name*:
Roman name (1):
Date of birth* (Month, Day, Year)		January February March April May June July August September October November December
Street address* (2):
E-mail address*:
Major subject*:		Classical Archaeology Roman History Greek History Roman Law Latin Ancient Philosophy Roman Military History Roman Religion Nova Roma
Secondary subjects:		Classical Archaeology Roman History Greek History Roman Law Latin Ancient Philosophy Rhetoric Roman Military History Roman Religion Nova Roma Not Decided Classical Archaeology Roman History Greek History Roman Law Latin Ancient Philosophy Rhetoric Roman Military History Roman Religion Nova Roma Not Decided
Comments:
* I have read eligibility requirements and I verify that all the information I have given above is accurate.

(1) If you belong into Roman organisation and/or wish to use a Roman or Latin name in Academia Thules.
(2) Street address is needed for sending you your diploma once you have finished your degree.