By signing below, I declare my belief in Baha'u'llah, the Promised One of God. I also recognize the Bab, His Forerunner, and `Abdu'l-Baha, the Center of His Covenant. I request enrollment in the Baha'i Community with the understanding that Baha'u'llah has established sacred principles, laws, and institutions which I must obey.
Signature: ____________________________
Date: (mm/dd/yy) _____________
Full Name: __________________________________
Address: _________________________________
City: __________________
State: __________________
Zip: ___________________
Country: ________________
Country/State of birth: ______________________
Sex: Male / Female
Birth Date: (mm/dd/yy) _____________
Telephone (Home): ________________
Telephone (Work): ________________
If you live within the United States, please use our automated web form so that your interest in becoming a Baha'i can be directed to the closest Baha'i institution. The web form can be found at: http://www.bahai.us/content/view/33/100/