CWPN Membership Application

This application should be filled out online, then printed and mailed to the address at the bottom.

I am looking to join a coven or study group
Legal Name
Address
City/State/Zip
Phone Number
E-Mail
Date of Birth
If you are under 18 yrs of age you must have written parental consent)
How did you hear about us?
I consider myself
What Denomination if any
Talents I would happily volunteer to the organization
please use back of form to describe the kind of group you are seeking and your own level of experience.
I have a group which would welcome new members
please use the back of this form to describe the group

Please include a check in the following amount:
Single membership: $30.00

Family membership: $40.00 (2 or more people living in the same house/apartment)

Coven Membership: $50.00 (up to 13 people, same coven)

CWPN; P.O. Box 1175; New Milford CT 06776-1175 Phone 860-354-7512