423 Application and Payment process

WE ARE AVAILABLE FOR QUESTIONS AT ANY TIME DURING YOUR APPLICATION PROCESS AT info@423COMMUNITIES.ORG.



For completion of this form you will be required to purchase our founder’s, Dave Scriven, Book The Pursuit of Porneia.

There will be a required $15.00 application fee for placement into 423 Communities at the end of this form.

Name *
Name
Phone *
Phone
Address *
Address
Date of Birth *
Date of Birth
I have read and fully understand: *
I have read and fully understand: *
I have read and fully understand: *
I have read and fully understand: *
I have read and fully understand: *
I have been given the opportunity to ask questions about each of the above forms and agree to their conditions. I am at least 18 years old and I want to join a 423 Men or 423 Women group. If I am 18 years old or younger and wish to join 423 Young Men or 423 Young Women, my parent or legal guardian has also read each of the above forms and authorized this application below. *
Applicant Electronic Signature *
Applicant Electronic Signature
Parent or Guardian Electronic Signature (18 years or younger only)
Parent or Guardian Electronic Signature (18 years or younger only)
Parent or Guardian Phone
Parent or Guardian Phone
I acknowledge that by typing my name above, I am agreeing to the conditions of this form and above documents, and that for the purposes of 423 Communities my typed name shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature. *
Please select as many group choices (up to five) since many groups are full. After joining a 423 group, you may transfer to other groups when vacancies occur.