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Membership Application

2015 MEMBERSHIP APPLICATION
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Monad Logo

TECHNOCRACY

INCORPORATED

MEMBERSHIP APPLICATION

Fillable Application – click on the line to enter data

 

I,                                                                                  , a citizen of the national entity of the North American Continent in which I reside,
hereby apply for membership in Technocracy Incorporated as follows herewith.

Address   ____________________________________________________________________
City   _______________________________________________________________________
St, Prov. _____________________________________________________________________
Zip, Post Code ________________________________________________________________

Phone # ____________________________

Email Address _____________________________

Spouse’s Name If applicable __________________________________________________________________

Schools Completed:  High School   Yes or No.          College  Yes or No

Name of Colleges or Universities:    ____________________________________
_________________________________________________
Dates       ___________________ _________________________________________________
Dates       ____________________

 

Present Employer _______________________________      Position _________________________

Start Date _________ Brief description of duties _____________________________________

Industry ________________________________________ Division ___________________________

Agriculture, health care, etc

Profession _________________________________ Field of specialization_______________

_____________________________________________________________________________________

 

 

Area you feel you would be of most service to Technocracy Inc.

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

 

 

Other organizations, hobbies, remarks ____________________________________________________

 

 

________

Date Rec’d

At CHQ

 

Application Approval

 

Application approved by: __________________________________________________________

(In the Field, Governor of New Membership committee, or Organizer)

 

Application approved by: __________________________________________________________

(At CHQ, Division of Organization)

 

FOR THE APPLICANT

Membership Dues:

Members-at-large:

The annual membership dues are to be renewed in January of each year. ($40 per year as of 2016) Applicants filing for the first time during any calendar month will have a prorated adjustment for the month of filing multiplied by the remaining months prior to the New Year.  Example:  member filing in May times six (months remaining) equals dollar amount. 

Payable to CHQ, Technocracy Inc. Ferndale, WA.  The formation of Sections, Units or Groups will base their dues on collections according to the Bylaws and General Regulations.

Included herewith is payment of dues, according to the requirements above ……………………………..$ _____________

Also included herewith is the price of the official Monad button or pin (circle one) $10.00  ………….$ _____________

 

I understand that certification of my membership in the form of a member’s identification card, bearing the facsimile signature of the Continental Director of Technocracy Inc. will be issued to me only after completing the study course classes and approval of my application by the Division of Organization, Continental Headquarters. Technocracy Inc., 2475 Harksell Rd, Ferndale, WA 98248

 

I am not an elected official or an officer of any political organization or party.  (I understand that the act of voting is not to be construed as constituting membership in a political part.)

I pledge to adhere loyally to the objectives of Technocracy Inc., and to comply with its Bylaws and General Regulations.

I certify that the information given herein by me is, to the best of my knowledge, correct.

Signed

Date of Application                                                                 Applicant

 

Note:  The following signature is required if the applicant is a minor.

I hereby attest that the foregoing information is correct, and I give my full permission for the applicant’s participation in the activities of Technocracy Inc.

Signed _________________________________________________________

Parent or Guardian

 

 

 

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