International Cultic Studies Association

Feedback Form

_________________________________________________

Please tell us what you think about our web site, our products, our organization, or anything else that comes to mind. We welcome all of your comments and suggestions. 1) What kind of comment would you like to send? Complaint Problem Suggestion PraiseQuestion Other 2) What about us do you want to comment on? Other: 3) Please provide the following contact information:
First name:	required
Last name:	required
Middle initial:
Title:
Profession:	required
Organization:
Work Phone:
Home Phone:
FAX:
E-mail:	required
URL:

____________________________________________^
4) Group information:
Tell us about the group of interest?
What type of group is it?	required
The groups name is:
Are you a:	required

______________________________________________ ^
5) Please provide the following mailing information:
Street address:
Address (cont.):
City:
State/Province:
Zip/Postal code:	required
Country:
_______________________________________________ ^
6) Select Free/Trial publications: (check all that apply)
Free Publication	AFF News Briefs E-mail newsletter
Free Trial	Cults & Society - Internet Journal
_______________________________________________ ^

7) Select your Username and Passcode (Trial Subscriptions only):
Username = e-mail address:	required
Challenge word = Example: mothers maiden name:	required
Year of birth"	required

Your user temporary password will be sent to you shortly.

8) Enter your comments in the space provided below:
9) Send your feedback:

______________________________________________ ^

You may also place your order by telephone, fax, snail mail, exclude:

your name, address, city, state, zip, telephone(s), fax, e-mail;

product ID number, names, and quantities of product

If you have any questions about your order/subscription, contact:
_aff_address

Order Line: _aff_tel_orderdept

E-mail: _aff_email_orderdept

______________________________________________ ^

Feedback Navigation

International Cultic Studies Association

Feedback Form

_________________________________________________

Please tell us what you think about our web site, our products, our organization, or anything else that comes to mind. We welcome all of your comments and suggestions. 1) What kind of comment would you like to send? Complaint Problem Suggestion PraiseQuestion Other 2) What about us do you want to comment on? Other: 3) Please provide the following contact information:
First name:	required
Last name:	required
Middle initial:
Title:
Profession:	required
Organization:
Work Phone:
Home Phone:
FAX:
E-mail:	required
URL:

____________________________________________^
4) Group information:
Tell us about the group of interest?
What type of group is it?	required
The groups name is:
Are you a:	required

______________________________________________ ^
5) Please provide the following mailing information:
Street address:
Address (cont.):
City:
State/Province:
Zip/Postal code:	required
Country:
_______________________________________________ ^
6) Select Free/Trial publications: (check all that apply)
Free Publication	AFF News Briefs E-mail newsletter
Free Trial	Cults & Society - Internet Journal
_______________________________________________ ^

7) Select your Username and Passcode (Trial Subscriptions only):
Username = e-mail address:	required
Challenge word = Example: mothers maiden name:	required
Year of birth"	required

Your user temporary password will be sent to you shortly.

8) Enter your comments in the space provided below:
9) Send your feedback:

______________________________________________ ^

You may also place your order by telephone, fax, snail mail, exclude:

your name, address, city, state, zip, telephone(s), fax, e-mail;

product ID number, names, and quantities of product

If you have any questions about your order/subscription, contact:
_aff_address

Order Line: _aff_tel_orderdept

E-mail: _aff_email_orderdept

______________________________________________ ^

Feedback Navigation

International Cultic Studies Association

Feedback Form

_________________________________________________

Please tell us what you think about our web site, our products, our organization, or anything else that comes to mind. We welcome all of your comments and suggestions. 1) What kind of comment would you like to send? Complaint Problem Suggestion PraiseQuestion Other 2) What about us do you want to comment on? Other: 3) Please provide the following contact information:
First name:	required
Last name:	required
Middle initial:
Title:
Profession:	required
Organization:
Work Phone:
Home Phone:
FAX:
E-mail:	required
URL:

____________________________________________^
4) Group information:
Tell us about the group of interest?
What type of group is it?	required
The groups name is:
Are you a:	required

______________________________________________ ^
5) Please provide the following mailing information:
Street address:
Address (cont.):
City:
State/Province:
Zip/Postal code:	required
Country:
_______________________________________________ ^
6) Select Free/Trial publications: (check all that apply)
Free Publication	AFF News Briefs E-mail newsletter
Free Trial	Cults & Society - Internet Journal
_______________________________________________ ^

7) Select your Username and Passcode (Trial Subscriptions only):
Username = e-mail address:	required
Challenge word = Example: mothers maiden name:	required
Year of birth"	required

Your user temporary password will be sent to you shortly.

8) Enter your comments in the space provided below:
9) Send your feedback:

______________________________________________ ^

You may also place your order by telephone, fax, snail mail, exclude:

your name, address, city, state, zip, telephone(s), fax, e-mail;

product ID number, names, and quantities of product

If you have any questions about your order/subscription, contact:
_aff_address

Order Line: _aff_tel_orderdept

E-mail: _aff_email_orderdept

______________________________________________ ^

Feedback Navigation

International Cultic Studies Association

Feedback Form

_________________________________________________

Please tell us what you think about our web site, our products, our organization, or anything else that comes to mind. We welcome all of your comments and suggestions. 1) What kind of comment would you like to send? Complaint Problem Suggestion PraiseQuestion Other 2) What about us do you want to comment on? Other: 3) Please provide the following contact information:
First name:	required
Last name:	required
Middle initial:
Title:
Profession:	required
Organization:
Work Phone:
Home Phone:
FAX:
E-mail:	required
URL:

____________________________________________^
4) Group information:
Tell us about the group of interest?
What type of group is it?	required
The groups name is:
Are you a:	required

______________________________________________ ^
5) Please provide the following mailing information:
Street address:
Address (cont.):
City:
State/Province:
Zip/Postal code:	required
Country:
_______________________________________________ ^
6) Select Free/Trial publications: (check all that apply)
Free Publication	AFF News Briefs E-mail newsletter
Free Trial	Cults & Society - Internet Journal
_______________________________________________ ^

7) Select your Username and Passcode (Trial Subscriptions only):
Username = e-mail address:	required
Challenge word = Example: mothers maiden name:	required
Year of birth"	required

Your user temporary password will be sent to you shortly.

8) Enter your comments in the space provided below:
9) Send your feedback:

______________________________________________ ^

You may also place your order by telephone, fax, snail mail, exclude:

your name, address, city, state, zip, telephone(s), fax, e-mail;

product ID number, names, and quantities of product

If you have any questions about your order/subscription, contact:
_aff_address

Order Line: _aff_tel_orderdept

E-mail: _aff_email_orderdept

______________________________________________ ^

Feedback Navigation