Registration Form/Temple of Azrael
(print this out and mail)
The Temple of Azrael
P.O. Box 26116
Colorado Springs, CO 80936-6116
Please enroll me as a registered member of The Temple of Azrael. Enclosed is a check or M.O. for $25.00 for one year, or $100 to cover my lifetime membership dues. Please make all monies payable to The Temple of Azrael.
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Name (Mr./Mrs./Miss/Lord/Lady/Dr./etc)
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Street (or P.O. Box)
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City State Zip Country
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Sponsor (if any)
Please give a brief reason for wanting to join the Temple:
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