APPLICATION FOR MEMBERSHIP Being in sympathy with the Three Objects, I hereby apply
for admission as a member of the Theosophical Society: Signature of legal guardian if under 18 years of age _________________________________________________________ Dues can be paid by check, money order, or credit card: _____ VISA _____ MasterCard _____Discover Card
#_____________________________________________________________Expiration
date_____________________ (Along with the 16 digit #, the additional 3 digit ID # on the back
of card is required for processing.) Signature required (for credit card payment) _____________________________________________________ 1-year membership—$45
2-year membership—$85
3-year membership—$125 Please send my series of New Member Letters in: English _________ Spanish_________ Name________________________________________________________________Birthdate________________________ Address_____________________________________________________________________________________________ City_________________________________________________State__________________Zip_______________________ Phone_________________________________Fax__________________________E-mail____________________________ How did you learn of the Society?________________________________________________________________________ If you have belonged to the Society before, please complete the following line: Name used______________________________When____________________________Country_____________________ Note: If the applicant is applying through a lodge or study center other than the National Lodge, the president or secretary of the group must complete and sign this section, then forward this form, along with the applicant's current national dues, to the National Secretary. Name of Lodge or Study Center__________________________________________________________________________ Signature of group officer___________________________________________________________ Date________________ -- National Center Use Only -- Signature of national officer_________________________________________________________ Date________________ Certificate
#______________________Date___________________Affiliation_________________Dues________$________
Basic Membership
$45 a year Student under the age of 25
$24 a year Member of a Local Lodge or Study Center
Consult your local group for its dues information Life Membership
$1,100 National Lodge
Consult the National Lodge office for its dues information Membership Benefits Your membership includes . . . |