PLEASE PRINT

 

To the Most Excellent High Priest, Excellent King, Excellent Scribe and Companions of:

 

BALDWIN CHAPTER NO. 17, ROYAL ARCH MASONS.

 

I, the undersigned, a Master Mason in good standing and a member of ________________Lodge No_____, F. & A. M., Located at ______________________ under the jurisdiction of_____________________, respectfully petition your chapter for the Mysteries of Capitular Masonry, and if found worthy to be elected, promise a faithful compliance with all the Laws, Rules and Regulations of Royal Arch Masons wheresoever dispersed.

 

 

I received the Degrees of Symbolic Masonry in _________________Lodge No._______ F. & A. M. located at_________________ under the jurisdiction of the Grand Lodge of _______________________

 

 

I have never before petitioned for the Capitular Degrees. (If you have, strike out the word “Never” and give Chapter Name, location, and action taken._______________________)

 

 

Date of Birth_______/_______/_______                                           Place of Birth________________________

 

Home Address________________________________                Home Telephone Number_(___)____-_____

City, State, Zip________________________________               Cell Phone Number          _(___) ____-_____

 

Employer_________________________                                          Occupation__________________________

 

E-Mail ___________________________                                          if Married, Wife’s Name________________

 

 

 

 

_________________________________                                          ______________________                ____________

(Print Name in Full)                                                                                 (Sign Name in Full)                               (Date)

 

Petition Fee            $ 30.00 With Application                                      Recommended By:

Chapter Fees          $ 12.00/Year

Balance   $_________                                                                               Companion__________________________

 

                                                                                                                       Companion__________________________

 

 

 

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