Certificate Application Form REQUIRED: Please print legibly and remember to sign the document Indicate your choice with a check mark for the kind of certificate you want: you may choose all three ( ) Religious Ceremonial Certificate for weddings & more... $25 minumum donation + $5 S&H = $30 ( ) Religious Cannabis Certificate for rites and prayers... $25 minumum donation + $5 S&H = $30 ( ) Gay Union Certificate... $30 minumum donation + $5 S&H Name: _______________________________________________________________________________________ as it will appear on the certificate(s) Name: _______________________________________________________________________________________ full legal name Title: ________________________________________________________________________________________ Date: ________________________________________________________________________________________ that will appear on the certificate(s) I, Name _____________________________________________________________________________________ have the sincerely held religious belief that I am... a Title ______________________________________________________________________________________. I agree to Maat (Truth and Justice) and will refrain from doing any harm. ______________________________________________________________________________________________ Signature: ______________________________________________________________________________________________ Mailing Address: ______________________________________________________________________________________________ Phone Number ______________________________________________________________________________________________ E-mail Address: Make an online donation or place a check, money order or cash and this document in a stamped envelope addressed to: Pr Ntr Kmt, c/o michaelm, 340 Old Newport Road #7, Newport Beach, CA 92663, U.S.A.. |
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per netcher kemet ![]() temple of divine in kemet |
neter sentra ![]() a sacred religious belief |
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