Introductory Pack Order Form

Please Note: Only Australian and New Zealand residents can apply using this form.

For residents of other countries, please contact your nearest centre through the School's International site www.lectoriumrosicrucianum.org

Please complete and post or fax this form to us at our contact address nearest you.
Your free Lectorium Rosicrucianum Introductory Pack will be posted to you shortly. 

The information you provide us is held in strict confidence. 

If you do not want us to retain your contact details, please indicate in the box provided in the form below. 

Please complete the following information; mandatory fields are marked *:

First Name or Initials *
             Last Name *
  	Postal Address *
 	Address (cont.)
       		  City *
  	State/Province *
       Zip/Postal Code *
               Country *
 Home Phone (optional) 
     E-mail (optional) 

We normally retain your contact details for 12 months in order to send you details 

of any public presentations we are holding in your region.

If you do not want us to contact you, please mark this box:

Copyright © 2005 Lectorium Rosicrucianum. All rights reserved.
Revised: July 08, 2008