Please complete the following form, print a hard copy, sign, and return to the Center. Keep a copy for your own records.

MONTHLY PLEDGE AMOUNT: $
THIS FIRST PLEDGE IS FOR THE FOLLOWING MONTH:
FULL NAME
I have read and received a letter outlining supporting membership in the Center for Sacred Sciences and agree to its principles.
SIGNATURE
DATE

MY CURRENT CONTACT INFORMATION:

WHAT TYPE OF SUBSCRIPTION WOULD YOU LIKE?
Electronic subscription to Center Community News and to Holos Journal
Paper subscription to Center Community News
Both of the above

ELECTRONIC SUBSCRIPTION EMAIL ADDRESS
Please use the current contact email address provided above for my electronic subscription.
Please use this alternate email address for my electronic subscription:

COMMENTS

Center for Sacred Sciences
1430 Willamette St., #164
Eugene, OR 97401-4049