RCPS Membership Application

Applicant Information

Name:                                                                                                                  Middle Initial:

Date of Birth:

Phone:

Cell Phone:

Current Address:

City:

State:

ZIP:

E-mail:

Convicted of a crime or felony:                If so, describe:

Why are you seeking to become a paranormal investigator?

Paranormal Investigation Experience

Paranormal Education:

Other Group Affiliations:

How long?

Certifications:

By:

Personal Equipment:

Additional Comments:

Emergency Contact

Name of a relative not residing with you:

Address:

City:

State:

ZIP:

Phone:

Relationship:

Reference 1

Name of a reference not residing with you:

Address:

City:

State:

ZIP:

Phone:

Relationship:

Reference 2

Name of a reference not residing with you:

Address:

City:

State:

ZIP:

Phone:

Relationship:

Signature

I authorize the verification of the information provided on this form as to my paranormal investigation experience.

Signature of Applicant:

Date:

For RCPS Use Only

Received:

Reviewed:

Decision: