The Consensus

APPLICATION FOR MEMBERSHIP.

I have read the Constitution of the Consensus, and being in accord with the views expressed wish to become a full member.

Full Name.___________________________________________________________________________

Address._____________________________________________________________________________

Post Code:______________ Telephone Number._______________________________

Date of birth: ___________

Email:_________________

Are you a current or former member of any formal political or religious organisation? YES/NO
Delete as applicable

If 'YES', please list below:

_______________________________________________________________________

I am willing/unwilling for the Consensus to make my contact details available to other members. [Please delete as appropriate.]

Attached is my annual subscription of £15.00. [ $25 or 25 Euros if non British]
{Please make cheques payable to the "The Consensus"]

Signed:_______________________________ Date.________________________

I swear to uphold in letter and spirit the Consensus Essentia:

Signed:_______________________________

Please return this form to:

The Consensus
22 Milburn Road
Bedford
MK41 0NZ
Email: dirk.bruere@gmail.com

ã The Consensus 2002