Your Age: Your Sex:

Your Country and Province/State/Region:

Your City:

What type of vampirism do you identify with?
(check all that apply)
Just VampireElementalEmotional PranicPsi/PsychicSanguineSexual

What type of membership are you applying for?
9th Cousin8th Cousin
(I agree with the Black Veil and the Genetic Merovech theory)

Tell us anything else you would like us to know:

Submitted By: