Digital Membership Form
First Name *
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Middle Initial
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Last Name *
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Birth Date *
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DD
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YYYY
Birth Place *
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Onegodian Rebirth Name *
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Closest Person to me is
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Address
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City *
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State *
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Phone
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email *
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Career/Study
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Workplace
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Most Important Need
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Favorite Foods (Top 2)
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Music or Movies (Choose one)
New to being a Member of an ORGANIZATION: (Yes or No) *
Religious affiliation: (Yes or No) *
Drivers License (Optional): (Yes or No)
I agree to abide by the ONEGODIAN Constitution and give permission to the Indigenous Nation of Onegodia to use the above information for organizational purposes. This document is confidential It will not be disclosed to any other parties. The purpose of signing this is to become a Certified Member of Onegodian, LLC. *
Signature (type full name)
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