Membership Application

Form 121651781290Ab-12nbA#1 Rev. 123

Part I

1) What is your name?:
2) What is thy Holy Name?:

3) Please tell me your E-Mail Address:

 

Part II
4) What would be your reason for joining?
5) What is the best way to Describe 5? 
Part III
 
6) Do you belive that the Dead Potatoes talk to you?

Yes. No.

 
7) Did you kill John F. Kenedy?
Yes. No.
8) Are you ever forced into descisions?
Don't Lie!
OYes. No.

Part IV
9) Please List your comments, or anything else you want to include:

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