Legal Name: __________________________________                            Date of Birth:     /    /

 Address: _____________________________________________________________________

Phone Number: ____________________     Mobile: _______________________

Email Address: ____________________________________________

Spiritual Name: __________________________________           Gender:    M / F / ?

Person to contact in event of emergency: ___________________________

 Contact Details: _______________________________________

Category of Membership applied for:

Seeker (    )                                                                Traveller (    )

Associate (    )                                                            Member (    )

Group (    )                                                                   Family (    )

 If applying for Family or Group Membership Please attach on a separate piece of paper details of Family or Group.

If applying for Internet (    ) or International Membership (    ) in any of the above categories please indicate.

 Declaration:

I acknowledge that membership in any category of FolkvangR Kindred, includes both responsibilities and obligations. I have read and accept the Constitution, Rules and Bylaws.

I recognise that FolkvangR Kindred is not a social club and declare Frith with all other members, even members I do not necessarily like or would not normally associate with. I declare loyalty to the ideals and objectives and Folk of FolkvangR Kindred, and to the Elder Traditions to which I seek and/or subscribe. If a Seeker, I declare that I will not knowingly work against the objectives and members of FolkvangR Kindred, and will abide by the constitution and rules of FolkvangR Kindred. I declare that I will not indulge in actions or statements bringing discredit upon myself, FolkvangR Kindred, and/or its officeholders or members.

I further declare my membership of any other spiritual or political group which may have a conflict of interest with the objectives and philosophy of FolkvangR Kindred.

__________________________                                            ___________________________

__________________________                                            ___________________________

Name: ____________________     Signature: __________________  Date:    /    /

This form is to be printed out and sent to an address which will be supplied by contacting folkvangr@iprimus.com.au