Membership Form - ESP Lab & SPIRITUAL SCIENCE CENTER
ESP LAB & SPIRITUAL SCIENCE CENTER
PO BOX 2883, Durango, Colorado, USA 81302
PHONE: 970-385-0888 & E-MAIL:
/NAME ______ADDRESS______
CITY ______STATE ______ZIP ______COUNTRY______
phone ______e-mail ______
Renewal of Old Membership [ ] Life Membership [ ] New member [ ]
Please enroll me as a member of the ESP Laboratory. I understand that this entitles me to the Monthly Newsletter, and Placing of my Name on your Prayer list for the Green, Blue and White Light.
Member's dues :
______months @ $2 month for USA, & @ $3 month for International
(Life membership is $220 for USA, and $330 for International) / $ ______
______Family members at $ 1 each / month / $ ______
______Family pets - group at $ 1 each / month / $ ______
Please enter the following names on the prayer list for the GREEN LIGHT of Prosperity: ______ / $ ______
Please enter the following names on the prayer list for the BLUE LIGHT of Healing: ______ / $ ______
Please enter the following names on the prayer list for the WHITE LIGHT of Spiritual Growth :______ / $ ______
Please enter the following names on the ALTAR OF DIVINE COMPANIONSHIP:
[ ] attract perfect mate / [ ] friends / [ ] promote marital bliss / ____ names at $ 1 each / $ ______
______Questions for the ALTAR of PSYCHIC CONTACT / $ ______
Intensive Treatment $ 50 / month or $ 25 / 2 weeks, (a suggested donation)
with personal service by Your ESP Lab staff & Merry Spirit Band!
For : ______Problem : ______Period:______at / $ ______
EXTRA HELP : I would like to donate extra to help further your work $ ______
SEED MONEY FOR : ______$ ______
Total Donation Enclosed $ ______Charge my cc#______Exp______
PLEASE SEND ME ADDITIONAL INFORMATION :
------I WOULD LIKE TO A SPIRITUAL READING (suggested donation $45) Please contact me.
HELP US GROW BY HELPING OTHERS
ESP LAB-- Please send our introductory literature to the names and addresses I have entered below:
Name ______Address______
City ______State ______Country______Zip ______
Name ______Address______
City ______State ______Country______Zip______