Membership Form

Affiliate Membership
Members receive discounts on certain events, 
invitations to certain members only events, and can apply for outer court.
$30.00 individual or $45.00 family - two adults plus children, one address
All dues are annual and due October 31st of every year.

Panthean Temple Pendants are purchasable by member's only
$65 each
Click here for T-Shirts and other merchandise 

Midnight's Child
Limited edition by artist 
Rev. Alicia Lyon Folberth

Panthean Temple Pendant
Solid Sterling Silver

Hand cast for us by Raven's Hoard Studio in Canada, created by 
Lady Tamarra James

Panthean Temple T-Shirt

Pentacle Logo 
printed on reverse
Our 100% cotton, 
Hanes Tagless T-Shirt is preshrunk


Sponsor us!

If you make your check out for:
$100.00+ - receive print 'Midnight's Child' 
$300.00+ - receive print 'Midnight's Child,' 
plus a Panthean Temple t-shirt.
$500.00+ - receive print 'Midnight's Child,' 
plus a Panthean Temple t-shirt, pendant.
$1000.00+ - all the above plus 4 passes to our Beltaine Festival

Would you like to directly sponsor an expense?
We can promote your business as a sponsor 
on our web site and Meetup group (which alone costs $150 a year)
We have storage bills, cable bills, telephone bills and web related bills.
We are a 501(c)3 organization, and your donations are tax deductible.



Name: _____________________________________________________

Name (as you would like it to appear on card):

          _____________________________________________________


Mailing Address:

__________________________________________________________

__________________________________________________________

__________________________________________________________

City ________________________________State_______Zip_________

Phone _____________________________________________

E-Mail _____________________________________________

Annual Dues: $________
Additional Donation: $_________
Pendant: $__________
Total Enclosed $________

All dues are annual and are due the October 31st of every year.
We reserve the right to deny membership.

Print out and mail with a Check or Money Order to: 
Panthean Temple
POB 111
Derby, CT 06418

If you would like to make a separate donation over the internet,
please send it via PayPal to PantheanTemple@aol.com