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Military Pagan Network, Inc.

Serving Neopagans and the Military Since 1992
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2007-2008 Membership Application
This form is for a Neopagan who would like to be a member of the Military Pagan Network and meets the membership criteria given in the Membership section of the bylaws. Please provide proof of military service in the form of military ID, DD214 or other service equivalent, and a check, money order, or PayPal payment in the amount of $10.00. To join for more than one year, simply add $10.00 for every year you wish to be extended. Family members who also wish to join may do so at half the price.

Membership in the Military Pagan Network, Inc., is from June 21 - June 20. Joining MPN at anytime will require renewal in June of the following calendar year.

Note: Each household member interested in membership must fill out separate applications.
Last Name First Name Middle Initial
Address Line 1 Address Line 2
City (APO/FPO)State (AE/AP/AA) Zip Code
Home PhoneOffice Phone Cell Phone E-mail
Branch of Service
(Active, Retired, Reserves, etc.)

Do you wish to be a Point of Contact?Yes No Enter your initials if you have read the
POC FAQ and understand your duties.
Base you will serve
Do you wish to be in some other volunteer staff position?Yes No
Additional Comments:

I have read the bylaws. I meet all membership requirements given in the bylaws and agree to provide proof of military service with this document. (full name)
Please review the information you have provided above before submitting this form.

Send proof of eligibility, applications, and/or payments to
Military Pagan Network
PO Box 1225
Columbia, MD 21044
Faz: 610.466.8076

Copyright 2006 Military Pagan Network, Inc.