EHE Network

EHE Network Membership Application

Name:	_______________________________________________________________
Mailing Address:	_______________________________________________________________
	_______________________________________________________________
	_______________________________________________________________
Daytime Telephone:	_______________________________________________________________
Fax:	_______________________________________________________________
Email:	_______________________________________________________________
Computer:	________PC _______Mac ______Other
We hope to use the information provided above as the basis of a directory of members, and to provide a copy of the directory to current members. May we have your permission to include the information above in the directory? Yes _____ No _____

What types of exceptional human experience are you interested in?

_______________________________________________________________________

What do you hope to get out of being a member of the EHE Network?

_______________________________________________________________________

List any ways in which you think you could help forward the aims of the Network.

_______________________________________________________________________

Which activities of the Network are you especially interested in?

_______________________________________________________________________

Do you wish the information in Part II to be kept confidential? Yes____ No ____

_______________________________________________________________________

III

An EHE membership qualification is to send in a written description of an EHE you have had. Please describe the experience in as much detail as possible, including circumstances that led up to it, any special physical, physiological, or emotional qualities of the experience, and any aftereffects associated with it. Please indicate whether or not the experience changed your life in any way, and if so, how.

If you have not had an EHE, please submit a firsthand account you have obtained from someone else. Failing that, please submit a published example of an experience you would like to have had, with complete bibliographic information. Please explain why you would like to have experienced it.

If you submit your own experience, would you please fill in the enclosed release form?

I hereby grant permission to the Exceptional Human Experience Network or its successors to enter my experiential account(s) into a database of experiences to be used in educating interested scholars and members of the general public about these experiences, and to publish it as an example in books and articles or in full in Exceptional Human Experience or EHE News. I understand that my name and address will not be revealed to anyone without my permission.

Name: _______________________________________

Choose one of the following:
Name_____________ Pseudonym___________ Initials ____ Code Number________

Thank you very much for answering the above questions, the questionnaires, and the release form. We are always interested in your ideas about EHEs and ways of studying them. Members may submit articles to either Exceptional Human Experience or EHE News.

Please return this sheet along with your dues of $40.00 payable in U.S. funds to the EHE Network, if you have not yet paid them.

Send applications/dues to:
EHE Network, 414 Rockledge Road, New Bern, NC 28562.
Important note: Add $6 if outside the U.S. (or $4 for EHE; $2 for EHE News). Thank you.

Note: Current subscribers to Exceptional Human Experience and EHE News may become members at no extra cost by filling out this form and sending an account of an experience. You will receive Background Papers as a benefit of membership.