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Petition for Membership
All information provided in your petition is kept confidential.
PETITIONER INFORMATION
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Nation of Citizenship
*
Phone Number
*
Email
*
Date of Birth
*
Sex
*
Male
Female
Marital status
*
Single
Married
Occupation
*
Previous occupation
*
Have you ever been charged, arrested, or convicted of any offense or crime (other than minor traffic violations)?
*
Yes
No
If yes, please explain nature of offense(s), dates of offense(s), and judgment(s) rendered.
*
ACADEMIC INFORMATION
Most recent school attended:
*
Dates attended:
*
Last degree earned and graduation date
*
Please list the same for any other colleges or universities attended, beginning with the most recent.
*
RELIGIOUS AFFILIATION
Do you affirm a belief in a Supreme Being?
*
Are you baptized?
*
Yes
No
If yes, in what tradition?
*
If you identify with a primary faith tradition, what is it?
*
FRATERNAL AND ESOTERIC AFFILIATIONS AND STUDIES
List any fraternal, initiatic, and religious organizations and Orders with which you have been affiliated, both past and present, including degrees received and dates received.
*
Have you ever been denied membership in or been suspended or expelled from any organization?
*
Yes
No
If yes, please explain.
*
Which Order are you petitioning (choose only one)?
*
Servants of the Divine Name
Ordre Martiniste of North America
Aesthetic Rose+Croix Order of the Temple and the Grail
Please elaborate on how you developed an interest in the Order and why you wish to join this particular Order.
*
*
By checking this box, I affirm the truth of these statements.
Submit
Home
Gnostic Church
Tradition
>
Maundate Solemne
Constitution
Name
History
Succession
Structure
>
College of Metropolitans
Churches
Calendar
Resources
Initiatic Affiliations
Ordre Martiniste
Aesthetic Rose+Croix
Contact