City of Adam Registration – SHECANIAH

Priest Name

Registrant Name

Which plan did you select?

Do you confirm that this account is just for yourself? *

Yes
No

Do you confirm that this account is for you and your spouse ONLY? *

Yes
No

If you have also children that you also want on the city of Adam and are eligible to join the site under your account (ages 13 - 19), select "NO". You must register for a family plan.

Name of Spouse *

How many people are you planning to register on this plan?

STOP

Do not approve account. User has selected the wrong plan. A refund must be issued and they must register for the proper plan.

(Contact Kh. Yaradan regarding refunds)

What are the names for the additional family members on your account?

Name *

Gender *

Age *

How long have you been listening to the House of Wisdom?

Layout

Number

Dropdown

Have you been consecrated in the 7th Covenant by the Priests at the House of Wisdom? *

Yes
No

On which date were you consecrated? *

Which priest offered your consecration offering? *

Do you understand the 7th Covenant consecration?

Yes
No

Why do you want to be a member of the House of Wisdom?

Are you of the lineage of Israel or the nations? *

Israel
Nations
Unsure

Priests: additional notes