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ATON Lodge and Order Info form

Your full name:
Your email address: (e.g.:

Your phone number (with country, city, area codes):

City/Town: State/Prov.: Post./Zip Code:

Are you associated with another Order and Lodge?

Please fill in the Information about Other Lodge Associations

Are you Pagan/Wiccan Based?   Yes, I am   No, Im not

Aquisition of Info for the Temple and Lodge

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