Application for Membership

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* Required information.
First Name *
Last Name *
Postal Address *
City *
State *
Zip Code *
Country *
E-mail Address *
Telephone Number
Date of Birth *
Age *
Occupation *
Currently *
Currently active in an Initiatic Order *
If yes, give the full name(s)
Comments
I declare... (Click on the Red?) * I declare that I do not support or ia am not a member of any extremist or terrorist organizations
I declare... (Click on the Red?) * I declare that I will keep confidential the process of initiation and the material I will receive from the KORC
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