This form may be printed or hand written and should be
sent to the American Region Secretary-
Dr. Wallace H. Spaulding
1206 Buchanan St.
McLean, VA 22101-2943
DECLARATION (Which must be made by those desiring to be admitted to membership of the Society of Mary.)
(block letters/ Full name)
Declare that I am a member of the Holy Catholic Church and that I conform to her Discipline and Precepts, and desire to be admitted a member of the Society of Mary.
RECOMMENDATION by a Priest (who need not necessarily be a Member)
From my PERSONAL knowledge of
I believe that he/she is suitable to be admitted as a member of the Society of Mary.