Submitted by daniel on Mon, 01/05/2015 - 18:50 1 Start 2 Complete Full Name * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Email address * City/Town * County/State Country * Experience in other esoteric orders and/or masonic orders Reason for wishing to join the Order of the Rose and Cross Other contact details You may wish to add a telephone number (with international dialling code), a skype username or even a full address. [optional] Consider yourself Christian? * Yes No Please note that it is a requirement for membership of the Order of the Rose and Cross that the member should consider themselves a Trinitarian Christian. The definition of the terms Trinitarian and Christian, however, are left up to the applicant/member. Belief in some concept of the Holy Trinity? * Yes No Undecided CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.