FELLOWSHIP OF THE AVATAR APPLICATION FORM
  Print out the following APPLICATION for FELLOWSHIP OF THE AVATAR.
   
  REQUEST FOR MEMBERSHIP
 
  • I desire to become a disciple of the Avatar and will sincerely and earnestly strive to live in harmony with Divine Law so that I may, by example, draw those around me to the "Path". I will work with all my might to establish the Brotherhood of  Man and the Christ-Kingdom on earth
   
 
  • Minimum contribution of $3.00 per month is required. Enclosed: $__________
 

Method of Payment
 

 

United States:  Check, Money Order or Visa/MasterCard
   
 

All other countries:  International Postal Money Order drawn from a U.S. Bank

 

or
 

International checks drawn from U.S. Funds
 

or, Visa/MasterCard drawn from U.S. Funds
  PLEASE PRINT
   
 
Name: _________________________________________________
Street Address: _________________________________________________
_________________________________________________
City: _________________________________________________
State: _________________________________________________
Zip Code: _________
Country _________________________________________________
Signature: _________________________________________________
   
  Mail Application to:
  Brotherhood of the White Temple
 

7830 Oak Way, Dept. A
  Sedalia, Colorado 80135 U.S.A.
   
  Please charge my Visa/Mastercard $ ___________________ . _______ ($6.00 minimum)
    CREDIT CARD NUMBER:  __ __ __ __   __ __ __ __   __ __ __ __   __ __ __ __
    EXPIRATION DATE: (4-digit):      __ __ (Mo.)  __ __ (Yr.)
   
  SIGNATURE:   x_____________________________________________________________