1. I have read and I endorse the Five Tenets of The Sacred Well Congregation of Texas.

2. I understand that my affiliation with The Sacred Well Congregation of Texas is voluntary and without obligation or condition of any nature other than to endorse and affirm in faith and practice the Five Tenets.

3. I understand that I may terminate my affiliation with The Sacred Well Congregation of Texas at any time simply by written request.

4. I request to join the membership of The Sacred Well Congregation.

Signature _____________________________________________________

Name _______________________________________________________

Address ______________________________________________________

City, State ___________________________________________________

Zip or Postal Country Code _______________________________________

telephone (optional) _____________________________________________

e-mail (optional) ________________________________________________

Please complete this page, and mail to:

The Sacred Well Congregation
PO Box 58
Converse, Texas 78109

You will be placed on the Congregation’s membership roll, and you will receive announcements of the dates, times, and locations of all Congregational public worship celebrations, festivals, and activities.

This form may be completed by e-mail to: pilgrim3@ix.netcom.com and will be valid without signature.

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