HERSIR
APPLICATION

Hirðmaðr Training Program *

I have successfully completed the Hirðmaðr Training Program

Herstal Allocation *

A Herstal has been assigned to me

Forn Siðr Membership *

I hold an active (non-expired) membership in Forn Siðr

Hersir Module Courses *

I have registered for the required Hersir Training Module Courses

Gender *

Male is defined as YX chromosomes, and female is defined as XX chromosomes.

Male (YX)

Female (XX)

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

(###)

###

####

Where do you live? *

Urban Area

Suburban Area

Rural Area

Wilderness Area

Do you smoke? *

Yes

No

Do you drink coffee on a daily basis? *

Yes

No

Do you gamble? *

Yes

No

Certification *

I certify all information provided in this application is correct.