Please make your check out to: Toronto Dowsers   Please note:  receipts: $5 extra and are issued upon request only.

Mail to:     Marilyn Gang                                 phone: (416) 322 - 0363    9:33  a.m. - 9:33  p.m.  EST
                 #816 - 225 Davisville Avenue 
                 Toronto, Ontario   M4S 1G9
                                                         PLEASE CHECK:    __ RENEWAL   __ NEW  MEMBERSHIP
       PLEASE PRINT CLEARLY

Name:_______________________________________________________________________________________

Address:______________________________________________________________________________________

City______________________________       Province ________________    Postal Code________________

Home Phone  (______)______________________ * Email address *  _________________________________

My dowsing   interest(s) (Write a "1")    /  experience(s)  (Write a "2")    are in the following areas:

ANCIENT TEACHINGS:  Astrology ____/   Egypt ___/   Kaballah ___/   Mayan Cosmology ___/  Sacred Geometry ___/
LOCATING:  Gas, Oil ____/   Lost people,pets,objects ____/    Minerals ____/    Treasure ____/    Water ____/
HEALING: Physical Body ____/   Emotional Body ____/   Mental Body ____/   My Community ____/   Our Planet ____/

Animals ___/   Earth Energies ___/   Energy Dowsing ___/   Essential Oils ___/   Native Wisdom ___/Geopolitics ___/
Helping Children ___/   Herbs ___/    Horticulture ___/   Nutrition ___/ Planetary Grids ___/   Power of the Mind ___/
Radionics ___/   Raising Consciousness ___/Remote Viewing ___/   Sound & Light (Color) work ___/   Vibrational Medicine___/
Other/Comment: _______________________________________________________________________

I would like to help with (circle):  computers,  publicity,  organizing,  group facilitating,  teaching,  demonstrating
Other: _________________________________________________________________________________

CONTRIBUTIONS:  Our operating costs are covered by member dues. Your extra contributions help pay for library materials, equipment, special projects.  Your contributions make this possible while keeping dues low for those who are "financially challenged".  Please do contribute whatever feels right for you.

Dues $_____ +  Your Contribution $_____  =  TOTAL ENCLOSED:  $_____  THANK YOU!
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For Toronto Dowsers administrative  use only:
Fee paid:   ________________    Date:         ________________ Rec'd by:   ________________