I hereby petition to be admitted to the St. Elias Alumni Association and present myself as follows:
Name: _________________________________________________________________

Address: ___________________________________City/Town: ______________

State/Country/Province:________________Zip/Postal Code____________

Phone Number: _____________________Fax Number _________________

E-mail: _______________________Web: http://__________________________

Citizenship: _________________________Birth Date: ____________________

I graduated at St. Elias School of Orthodox Theology on _________________with the Degree of __________________________________________

___________I am also interested in being an Associate Member (A. Theol.)* Associate membership may be conferred by the School upon those who have made a notable contribu-tion to the advancement of the Orthodox Faith. [Art. III.6, Gen. Regulations]

___________I am also interested in the appointment of Fellow (F. Theol.)* The grade of Fellow may be conferred by the School upon those who have made a distin-guished contribution to the advancement of St. Elias School of Orthodox Theology. [Art. III.7, Gen. Regulations]

*Certificates, ready for framing, will be issued to all Fellows and Associate Members; and they may freely use their respective Postnomial.

The following minimum Donation is enclosed:

____$100 Member of the Alumni Association
____$500 Associate Member of Theology (A. Theol.)
____$750 Fellow of Theology (F. Theol.)
____$800 Benefactor
____$1000 Grand Benefactor

Donations will be placed into a special account for scholarships designed to help needy students as determined by the Administration and the incarcerated enabling them to enroll in St. Elias School of Orthodox Theology courses or programs as part of their rehabilitation process.

_______I request a receipt for tax deductible purposes.

Your contribution is deductible to the fullest extent of the law as no goods or services were received. Please retain such receipt in your records as verification of the above donation in compliance with IRS regulations.

Signature:____________________________________Date: ______________________

[Please make your check or money transfer payable to "St. Elias School of Orthodox Theology" and send it with this Petition to: 139 North 3rd Street, Suite 7, Seward, NE 68434. - International Applicants: Use the convenience of Bank Transfer. Ask for details. Never send cash in the mail]

We accept

and MasterCard