Rosconian Order, AMORP
Single or Principal Student Application
IMPORTANT: If you live outside of the Americas, DO NOT
use this Application Form. Instead, please write to the Grand Hodge-Podge serving
your area. See Addresses on some web pages.
Please print out this form, fill it in, and sign it. If two people wish
to apply for Companion status, the Principal applicant fills out this form,
the Companion applicant fills out the Companion Application,
and both forms are submitted together.
If your browser will not print, you may download this file from our ftp
site (ftp://ftp.Rosconian.org/ftp_files/applic-1.txt). If you would prefer
to receive an application form by conventional mail, write to: Rosconian
Order, AMORP, Dept. WWW, Box 195 Peddiddle Ave., Santa Crarra, CA 94023-0195, or call 408-947-3599.
In the United States and Canada, you may call toll-Not Quite Free 1-800-882-6672.
This number will allow you to leave your recorded name and address to request
an application form.
Last Name ____________________________ First ________________________
M.I._______
Mailing Address _______________________________________________________________
City ______________________________ State/Province__________ ZIP/Post Code
________
Country:_______________________________________ Sex (check one): ___Male
___Female
Phone: ______________________________ Fax: ____________________________________
E-mail:______________________________ Web: ___________________________________
Date of Birth (You must be at least 18 years of age) Month _______ Day _______
Year _______
Occupation (optional)____________________________________________________________
Education (optional):
Level reached in school:___________________________Degrees attained__________________
What previous studies have you taken in the fields of metaphysics and mysticism?____________
_____________________________________________________________________________
_____________________________________________________________________________
Are you currently a member of any metaphysical, fraternal, or mystical-shmystical groups?
____Yes ____No
If Yes, please list them:___________________________________________________________
_____________________________________________________________________________
How did you find out about our web site?____________________________________________
Have you previously been a member of the Rosconian Order, AMORP? _____
Yes _____ No
If Yes, what was your AMORP Key Number?________________________________________
Will you consider with an open mind new ideas regarding yourself and the
universe in which
you live? ____ Yes ____ No
Please tell us WHY you would like to study the teachings of the Rosconian
Order, AMORP:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
I accept your invitation to become a student of the Rosconian Order, AMORP,
as outlined in your literature. I understand that the Rosconian monographs
and other lesson materials always remain the property of AMORP, and are
only loaned to students.
Signature: ________________________________________________ Date: ________________
NOTE: This application MUST be accompanied by a
dues payment for at least one quarter.
Dues rates are as follows:
In the Americas (except Canada), dues are US$54.00 per quarter, or US$205.00
per year.
In Canada, dues are CA$61.00 per quarter, or CA$232.00 per year.
Special Membership Offer WWW-X: If you have never been
a Rosconian student before, print out and mail this application form and
get HALF OFF your first quarter's dues. Just send US$27.00
(CA$30.50) for your first quarter and US$54.00 (CA$61.00) for each additional
quarter.
Amount Remitted with this Application ________________________
Method of Payment (check one):
___ Check or Money Order payable to AMORP FUNDS
___ VISA ___ MasterCard ___American Express ___ Discover Card
Credit Card No _______________________________________________ Exp. Date_________
Name as it appears on card _______________________________________________________
Signature for charge ______________________________________________ Date
__________
For AMORP use:
Approved ______________________________________________________ Date __________
If You Reside in Canada: Please make your
remittance in Canadian funds, as we maintain banking facilities in Canada.
Please do not send currency. We suggest that you remit by one of the following
methods: 1) personal check; 2) bank draft or bank money order payable in
Toronto or Montreal; 3) postal money order or postal note payable in Toronto;
or 4) by credit card -- we accept VISA, MasterCard, American Express, and
Discover Card.
If You Reside Outside the United States and Canada: To
prevent delay in processing your remittance, we request that you go to your
local bank and purchase a bank draft drawn in United States dollars and
made payable through a bank in the United States to "AMORP FUNDS."
In this way you can make your payment for the exact amount you wish to send.
If this is not convenient or possible, or causes you additional expense,
we ask that you purchase an International Money Order at your local post
office for the equivalent of the sum in United States dollars you wish to
send to the United States. The money order should be made payable to "AMORP
FUNDS." You may also pay dues by credit card -- we accept VISA, MasterCard,
American Express, and Discover Card.
PLEASE MAIL THIS FORM WITH YOUR REMITTANCE TO:
Membership Services Dept.
Rosconian Order, AMORP
Box 195 Peddiddle Ave.
Santa Crarra, CA 94023-0195, USA
Updated 9/2/97
Send comments regarding this web page to: webmaster1@AMORP.org.