Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAge *Phone NumberPhoto of your ID/Driver Licences/Passport * Click or drag a file to this area to upload. Do you work for Law Enforcement or Any Government Agency? *YesNoWho do you work for? *Do you accept Entheogenic Plants (including cannabis and mushrooms) as part of your religion? *YesNoWhat is an Entheogenic plant?Do you agree to follow the rules and regulations of the Church? *YesNoDo you smoke, consume, or use Cannabis in any way? *YesNoDo you support the private Adult use of Entheogenic Plants? *YesNoWhat is an Entheogenic plant?Do you think Adults should have a safe place to use and/or acquire Entheogenic Plants? *YesNoWhat is an Entheogenic plant?Who were you referred by (Name & Member Number)? or Where did you hear about Zide Door? *Why do you want to join the church? *PhoneSubmit If approved you will be contacted in 2 to 7 days.
