Name:
Address:
City, State, Zip
Country:
Phone:_________________ (We will not call you unless it's dire...)
Email Address:
Date of Birth:
Gender:  ___ Male  ___ Female
Marital Status:  ___Single ___Married ___Divorced  ___Too long a  story for this space
Number of Children:  ___ Boy(s) ___ Girl(s)
Partners Name:

ORDINATION
Choose how you want to be Ordained (more than one is okay)
____ Spiritual Minister
____ Interfaith Minister
____ Psychic Minister
____ Esoteric Minister
____Rabbi
Other Title (Please describe) ___________________________________
You may choose more than one title from the above list for an additional $20 fee. (Separate certificates.)
Please enter your name exactly as you want it to appear on your Ordination Certificate:
(Most people include their middle name.)_____________________________________________________________

Why do you wish to become a counselor/minister?

Any experience as a counselor (including informal, with family or friends?)

Do you pledge to use your Counselor/Minister Status for the Service of Humanity?

Please tell us in one or two paragraphs how becoming ordained will help you in your current work.

MEMBER PROFILE
The following questions are somewhat optional, but we encourage you to answer them because they help us build a picture of you and what has made you the person you are. Souls appear and re-appear in "families" or "soul groups". They often follow family bloodlines, you ARE your ancestors. Past lives are sometimes hard to believe in, but genetic memory is very real. The things you are drawn to in life, flashbacks, and deja vu are your genetic memory nagging you. We can better help you get where you're going if we have a complete profile of you and your ancestral background.

What religion  were you raised on?

Do you still practice its ways?  ____  Fully     ____ Somewhat     ____ Seldom      ___ Never

How does your immediate family feel about your chosen spiritual path?  Opposition?  Approval?

Please check any of the following areas you have studied or "dabbled" in:
__Kabbalah
__Esoteric Christianity
__Runes
__Rosicrucians
__Gnosticism
__Wicca or Earthbased Trads
__Angels
__Judaism
__Buddhism
__Ceremonial Magick
__Tarot
__Enochian
__Goddess
__Apocalyptic/ Prophecy studies
__Druidry
__Vedanta/Hinduism
__Other areas of study not listed above:

Please list the subjects above that you are most interested in learning MORE about:

Your Occupation:

Your skills:

Hobbies, etc:

How did you hear about us? Check all that apply
__In a book
__Link from TheDreamZone.com
__Friend, Colleague, Family Member
__Discussion List or Forum
__Link from any other website (which one?)_________________________
__Search Engine Query
__Facebook
__Katia's Esoteric Christianity Blog
__Any other source: (please explain)

Please check the box next to the items you are ordering.  
__The Ordination fee is $156 (includes Priority Mail shipping)
__A Second Ordination Title is $20
__Wallet ID credentials are available for $10.
__Photo Badge ID -- $15(please send a passport style picture, by snail-mail or by email attachment)
__Beautiful white hardback Interfaith Minister's Manual  We have them available immediately (they take 4-6 weeks from Amazon). It includes ceremonies and rituals from strict Catholic to Native American. The cost is $31, which includes Priority Mail shipping.

__Check this box only if you want Rush shipping.  Cost varies, depending on where you are.

Payment Methods  (please put an X next to your desired method)
___Visa
___MasterCard
___Discover  (We accept checks and credit cards via PayPal on-line)
___Check or Money Order made payable to Esoteric Interfaith Church, Inc.

Did you submit your Spiritual Biography to Seminary@NorthernWay.org?

 If no, please do so after finishing this application, or include it with this application via email.

Your application will be reviewed and you will be notified immediately upon acceptance.

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