|
The Academy for Spiritual and Consciousness Studies, Inc
MEMBERSHIP APPLICATION
Date_____
Please enroll me as a member of The Academy for Spiritual and Consciousness Studies, Inc in the membership category marked below. Enclosed are my
annual membership dues in the amount of $________
for the year beginning_____20_____
__U.S. : $25.00
__Canada: $35.00
__International: $45.00
In addition to my annual dues, I'm enclosing a DONATION of $_____
to support the ongoing work and programs of the Academy.
(Contributions to The Academy for Spiritual and Consciousness Studies, Inc.,
are deductible for income tax purposes under an Internal
Revenue Service Section 501 (c) (3) ruling)
Name____________________________________
Address__________________________________
City_______________
State______
ZIP________ Telephone ( )___________________
E-mail Address My present position, qualifications, and terminal degrees are as follows: (For completion by those applying for Academic Membership. Please attach biographical sheets, outlines of work accomplished, etc., if available.) Please consider submitting appropriate articles, papers, research proposals or abstracts for possible publication in The Journal for Spiritual and Consciousness Studies. Please print, complete and mail this form with your check or money order made payable in U.S.A. funds to The Academy for Spiritual and Consciousness Studies, Inc and send to:
THE ACADEMY FOR SPIRITUAL AND CONSCIOUSNESS STUDIES P.O. Box 84 Loxahatchee, Florida 33470 (516)714-1423 [email protected] |