New Member Information

Name*

First Last

Address*

Mailing address City State / Province / Region ZIP / Postal Code

Your Birth Date*

E-mail*

Cell Phone (enter ten zeroes if you do not have a cell phone)*

Other Phone (enter ten zeroes if you do not have another phone)*

Profession

Special Skills

Children at home (names and ages)

New Member Agreement*

I choose to become a member of the Center for Spiritual Living, Santa Rosa and agree to support it financially and spiritually. This means I agree to complete an annual giving intention form, and to support the Center and its people in my daily spiritual practice.

I agree.

Today's Date*

Center for Spiritual Living

SANTA ROSA

New Member Information

New Member Information

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