Twitter Ecclesia Rosicruciana Apostolica Membership Application First Name * Last Name * Email Address * Home Phone Number Mobile Phone Number Home Address - Street Home Address - State Home Address - City Home Address - Zip Code Home Address - Country Date of Birth Country of Birth Country of Citizenship Time of Birth (If known) City of Birth Country of Residency Gender Male Female Marital Status Single Married Separated Divorced Widowed Were you Baptized? Yes No I don't know If you were baptized, what is your baptismal name? Nick name How did you hear of the Rosicrucian Apostolic Church? Please list below all Mystical, Esoteric, Occult or Fraternal organizations in which you are currently active Do you have any travel restrictions? Number of Children Provide the full name of a member of the Church who would be willing to sponsor your membership Do you have any personal, professional, economic or any other constraints that would prevent you from fully participating in required Church activities? Yes No Church Membership (Select all that apply) Regular Church Member Clergy Training Holy Orders If you are interested in clergy training, provide below an autobiographical essay detailing your understanding of this particular calling reCAPTCHA *