e-mail me

 

Please print the form below, fill it out, and mail it to the Lyceum of Alexandria Mishigami, 6122 S. Kenwood Ave., Chicago IL  60637...

Thank you!

************************************************************************************

Please enroll me in the Manifesto Lessons class.

Please check:_____ I want to participate in person

                        _____I want to participate by correspondence through the postal mail

                       _____I want to participate by correspondence through email

                        _____I am a member of the Fellowship of Isis

                      _____I want to join the Fellowship of Isis through the Lyceum of Alexandria Mishigami (click here for membership form: www.foichicago.org/membership.html)

NAME:______________________________________________________________________________

ADDRESS:___________________________________________________________________________

CITY:______________________________________________STATE:___________________ZIP:______

PHONE NUMBER:________________________________________

EMAIL ADDRESS:__________________________________________________________

Please send me section one of the Manifesto Lessons.  I am aged eighteen years or older.

 

SIGNATURE:_____________________________________________________DATE:_________________







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