PETITION TO THE STATE OF OREGON

For: INITIATION AFFILIATION DUALMEMBERSHIP To the Officers and Members of: Chapter No. Royal Arch Masons Council No. Cryptic Masons Commandery No. (Check only those to which you are applying) Petitioners Full Name Date Home Address Phone I hereby certify that I was regularly Initiated, Passed, and Raised to the Sublime degree of Master Mason in ______Lodge No. ______A.F.&A.M F.&A. M. (circle one) located at ______. That I have never been proposed and rejected in any Masonic Bodies; (If so, give details) ______. That I have resided in the State of Oregon for ______months and within the jurisdiction of Oregon Bodies for _____ months. (Commandery petitioners must have lived in Oregon for at least one year and within the jurisdiction for at least six months prior to application.) If found worthy, I promise a cheerful compliance to all the regulations and ancient usages and customs of the York Rite of Masonry.

Date of Birth Birth Place Occupation Business Address

Date Signed Recommended

INITIATION FEE AND CURRENT YEAR'S DUES MUST ACCOMPANY THIS PETITION TO: Chapter No. Royal Arch Masons Initiation Fee Paid Yearly Dues * If for Affiliation or Dual Membership: Formerly (or presently) a member in good standing of ______Chapter No. ______, Royal Arch Masons, located at ______as shown by the attached Demit or Certification of good standing.

Signed TO: Council No. Cryptic Masons Initiation Fee Paid Yearly Dues * If for Affiliation or Dual Membership: Formerly (or presently) a member in good standing of ______Council No. ______, Cryptic Masons, located at ______as shown by the attached Demit or Certification of good standing.

Signed TO: Commandery No. Knights Templar Initiation Fee Paid Yearly Dues If for Affiliation or Dual Membership: Formerly (or presently) a member in good standing of ______Commandery No. ______, Knights Templar, located at ______as shown by the attached Demit or Certification of good standing.

Signed

* Yearly dues are due upon completion of the degrees/orders but may be included as part of the fees paid. Check with your Secretary/Recorder for more information