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Membership Application Form

To renew your membership please go to the Renewal form

   Please fill this form in carefully: your accuracy will help us greatly.
    You don't have to fill in any details you don't wish to, but the questions below help us help members to network. None of your details will be divulged to non-members under any circumstances.
    When you click on any of the links below, a new window will open, so that this form will still remain in your browser with any information you have already filled in.

Last Name *		* = Required field Please type details carefully.
First Name *
Street address *
City *
State *	US and Canada: Outside US & Canada, please type state or other administrative division:
ZIP code *		If you would like the option of meeting other pantheists in your area, please include your zip code.
Country *

Phone *		Please include area code
E-mail * [Please enter twice - this is important]	Please snter your email again	Please type in your FULL e-mail address NO E-MAIL? Please type NONE in top box and your name in second box.
Web Page		Your Web site URL if any
Age Range
Gender
Job
Date joined *
Mailing list	Please choose which list(s) you want to join Community/practice Ideas/theory Pantheist Spirituality - all types of pantheism None	Have you read the list descriptions before choosing a list?
Referrer		If you saw an advert, please say where you saw it.
Religious group		Current religious group(s) you belong to, if any.
Why I am a pantheist*		Please type in a few sentences about your pantheist ideas or why you are a pantheist. We use the best of these on our Why I am a Pantheist page. Please indicate if we may use your statement :

SUBSCRIPTION DETAILS
Member level *		See Subscriptions page for benefits.
Amount paid *		Please enter the total amount paid including any donation.
Payment method * *See below for instructions	Credit Card Check by post
PLEASE FOLLOW INSTRUCTIONS BELOW, THEN PRESS "SUBMIT FORM"
CREDIT CARDS
Credit card subscription is available from most developed countries plus Mexico, Brazil, Israel, South Afirca, South Korea, Hong Kong & Singapore.		Please go through the Paypal process, then come back here. This window will remain open. About Paypal
Difficulties with Paypal? Check out their US help or International Help. If your problem is not answered there, contact Paypal's Customer Service Department. If you think the problem relates to WPM pages, email us at paypalquery@pantheism.net
CHECKS ETC
US $dollar checks, money orders or international money orders	Please print this form and post it with your check to: World Pantheist Movement 131 North Ludlow Street, Suite 1311 Dayton, OH 45402-1111 United States	Printing problems? Check the troubleshooting page for answers.
UK £sterling checks	Please print this form, and post it with your check to: The World Pantheist Movement PO Box 18687 London NW3 2FG, United Kingdom
Please double check your entries, especially address and e-mail fields, and then:

Contact us: wpm@pantheism.net

Membership Application Form

SUBSCRIPTION DETAILS

CREDIT CARDS

CHECKS ETC