ACT OF APOSTASY

To whom it may concern,

I, the undersigned, _____________________________________ hereby certify that I no longer consider myself

SURNAME, Given Names
to be a Raelian, nor do I wish to be counted or represented as a member of the Raelian Movement nor any of its

various national and regional organisations.

I exercise my right to freedom of thought, conscience and religion under Article 18 of the Universal Declaration of

Human Rights and ask that my choice be respected and actioned accordingly.

Additionally, I ask that the records of the Raelian Movement be updated to indicate that I have apostatised from

the organisation on this date, and that I no longer recognise Claude Vorilhon as the Last Messenger of the Elohim,

and that confirmation be sent in writing to document this.

I declare that I have made this decision independently after careful consideration and reflection, free from

coercion, in the presence of the two undersigned witnesses.

Consequently, I make this act of Apostasy in ____________________________ dated ____ /____ /____
City, Country DD / MM / YYYY

Signed: __________________________
Your Signature

WITNESS 1: WITNESS 2:

Name: ______________________________ Name: ______________________________

SURNAME, Given Names SURNAME, Given Names

Signed: ______________________________ Signed: ______________________________

Witness 1 Signature Witness 2 Signature

Dated: ____ /____ /____ Dated: ____ /____ /____

DD / MM / YYYY DD / MM / YYYY

MY DETAILS:

Address for return corespondence: Email:

______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Last Country of Membership:
______________________________________________
May have been known as:
______________________________________________

WWW.RAELIANTRUTHNETWORK.ORG/APOSTASY