Member Pledge Form


Contact information


Full Name(*)

Please type in your full name

Email for receiving official messages from CSS staff (private)(*)

Please type in your email address.

Email to appear in member directory (accessible to members only)




PLEASE DOUBLE-CHECK THAT YOU HAVE CORRECTLY TYPED YOUR EMAIL ADDRESS(S) ABOVE


Phone (including area code)(*)

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Street Address(*)

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City(*)



State

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Zip

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Country

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Membership pledge


Amount of monthly membership pledge (for each month from September through August)(*)

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Your monthly dues can be placed in the donation box or mailed to Center for Sacred Sciences, 1430 Willamette St. #164, Eugene OR 97401-4049
Acknowledgment(*)

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Group(s)


Which groups do you intend to participate in? (This is not official registration. To register, show up to the first class or contact the teacher directly.)(*)

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Subscription preferences


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Please select at least one option






CSS relies almost entirely on volunteers to operate. Are you interested in being a volunteer?

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Following are some of my interests, skills, expertise, talents, passions, assets, etc. that I have to offer CSS, and my volunteer limitations (physical or time constraints)



Please click the box:

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Click the button below to submit this form. NOTE: You should see a confirmation message after clicking the submit button. If you still see the form, please review, correct, and click submit again.