Membership Form    -    ESP Lab
P. O. Box 2883 DuRAngo, Colorado 81320-2883
 
NAME ___________________________ADDRESS_____________________________
CITY _________________________________STATE ________________ ZIP _______
Renewal of Old Membership [ ] Life Membership [ ] New member [ ]
Please enroll me as a member of the ESP Laboratory. I understand that this entitles me to the Monthly Newsletter, and the Placing of my Name on your Prayer list for thr Green, Blue and White Light.
Member's dues :  
________ months @ $ 2 / month ( $3 / month outside North America )  $ _________
________ Family members at $ 1 each / month  $ _________
________ Family pets - group at $ 1 each / month  $ _________

Please enter the following names on the prayer list for the GREEN LIGHT of Prosperity : __________________________________________________________

$ _________
Please enter the following names on the prayer list for the BLUE LIGHT of Healing : __________________________________________________________ $ _________
Please enter the following names on the prayer list for the WHITE LIGHT of Spiritual Growth : __________________________________________________________ $ _________
Please enter the following names on the ALTER OF DIVINE COMPANIONSHIP ;
[ ] attract perfect mate [ ] friendship [ ] promote marital bliss ____ names at $ 1 each $ ________
______ Questions for the ALTAR of PSYCHIC CONTACT $ ________
Intensive Teatment $ 50 / month or $ 25 / 2 weeks, or any personal service by Al Manning & TexLab Spirit Band
For : _______________ Problem : ________________ Period___________ at $ ________
EXTRA HELP : I would like to donate extra to help further you work                                    $ ________
SEED MONEY FOR : ______________________________________                                       $ _______
                                                                           Total Donation Enclosed       $ ______
PLEASE SEND ME :
[] ESP LAB Catalogue [] Membership Info to Astral Lab [] Membership Info to Astral Coven [] Lottery Program
HELP US GROW BY HELPING OTHERS
ESP LAB : I suggest that you send our introductory literature to the people whose names and addresses I have entered below.
Name ________________________ Address_________________________________
City ____________________ State _________________ Zip _________________
Name ________________________ Address_________________________________
City ____________________ State _________________ Zip _________________
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