Membership Checkout Membership Level change You have selected the Applicant membership level. Apply to Become a Member of the Church of Psilomethoxin The price for membership is $0.00 now. Do you have a discount code? Click here to enter your discount code Discount Code Account Information Already have an account? Log in here Username Password Confirm Password Email Address Confirm Email Address Full Name LEAVE THIS BLANK application Dear prospective member: Thank you for taking the time to apply for membership with our Church. In filling out the application, please note the following: we prefer to approve only those applicants which have been referred by an existing member. If you do have a referral from an existing member, please insert their name, as registered in our system, into the box asking how you heard about our Church. If you do not have a referral from an existing member, please be as thorough as possible in your answers to the application questions. In the event you are denied, more than likely you did not enter sufficient information for us to make an informed decision; and consider submitting another application if you feel so called with more detailed answers. If you have any questions, please feel free to email us at info@thesacredsynthesis.com — First Name Last Name Date of Birth JanFebMarAprMayJunJulAugSepOctNovDec How did you learn about the Church of The Sacred Synthesis? Did an existing member refer you? If so, who? Are you opposed to the shamanic, ritualistic, spiritual, and/or religious use of sacred entheogens such as Psilomethoxin? Please state your postion What has been your most profound experience and/or insight that you have received so far working with Entheogens. If you have not yet started working with them, what has brought you here? Have you ever attended a sacred ceremony, or held a personal religious ceremony involving the consumption of sacred entheogenic sacraments? In the event you are selected as a member in the Church, do you agree to follow specific rules and guidelines as established by the Church? Have you done your own research regarding our sacrament, Psilomethoxin? If so, what did you learn about it? Due to the lack of a reference sample for Psilomethoxin, the Church is currently unable to verify its existence within its sacrament. Do you understand this and still wish to proceed? By Checking this box, I agree to proceed with my application YOU MUST BE 100% TRUTHFUL AND ACCURATE IN COMPLETING THIS FORM. By putting your name HERE you recognize all statements are true and accurate: Disclaimer: This website is for information and educational purposes only and is not intended as medical advice. As with anything consumable, please consult your medical provider, prior to consumption. Every individual is different and may react differently to different substances. Consult your physician about interactions between medications and/or supplements you are taking. Comments made on this site or in any other online forums, made by employees or site users, are strictly their own personal views, made in their own personal capacity, and are not intended as a substitute for appropriate medical care or advice from a healthcare professional. The Church of Psilomethoxin makes no medical claims on efficacy. THIS PRODUCT IS NOT INTENDED TO DIAGNOSE, TREAT, CURE, OR PREVENT ANY DISEASE.Do not use if you are pregnant or nursing. Store in a cool, dry place. KEEP OUT OF REACH OF CHILDREN. I have read and acknowledge the disclamer. Phone Number by submitting this form and signing up for texts, you consent to receive marketing text messages from The Sacred Synthesis at the number provided, including messages sent by autodialer. Consent is not a condition of purchase. Msg & data rates may apply. Msg frequency varies. Unsubscribe anytime by replying STOP or clicking the unsubscribe link (where available). Review our Privacy Policy & Terms for more. Please reply with a checkmark to approve. Thank you!” Payment Information We accept all major credit cards Card Number Expiration Date CVC Discount Code Processing…
