MEMBERSHIP APPLICATION FOR THE Ancient and Accepted Scottish Rite of SOUTHERN JURISDICTION OF THE OF AMERICA ORIENT OF OKLAHOMA – VALLEY OF GUTHRIE Date ______I respectfully petition to receive degrees from the 4th to the 32nd, inclusive. The following information is given upon my Masonic Honor: (Please print name in full – do not use initials) Name ______Date of Birth ______First Middle Last Address______County______Street City Zip Place of Birth ______Home Phone ______Work Phone______Cell Phone______email______Wife’s name______Occupation ______Employed by ______If retired, indicate what from

MASONIC INFORMATION Applicant must be Master Mason in good standing in Blue Lodge: Name of Blue Lodge ______No. ______, A.F.&A.M., situated in______Under the jurisdiction of the of ______. Date raised a Master Mason ______Date of Proficiency ______

OATH OF ALLEGIANCE I, the undersigned, do hereby promise and swear true faith, allegiance and fealty to the Supreme Council of the Thirty-Third Degree of the Ancient and Accepted Scottish Rite of Freemasonry, for the Southern Jurisdiction of the United States of Ameri- ca, and will support and abide by its Constitution, Statutes, Orders and Degrees. That I will keep this trust as long as I reside within its Jurisdiction. Other Bodies established in the same Jurisdiction not holding its power immediately from said Supreme Council will not be communicated with nor will they be allowed to visit any Body of the Rite of which I may be a member and be held illegal and spurious. I promise to dispense Justice to the breth- ren according to the Laws of Equity and Honor. I approve and will uphold the fundamental principles, as announced by the Supreme Council, of patriotism, respect for Law and Order, Loyalty to the principles of Civil and Religious Liberty, Separation of Church and State and oppose any attempt to appropriate public monies – Federal, State or Local – for the support of sectarian or private institutions. Should I violate this, my solemn vow and pledge, I consent to be expelled from Masonry, the Rite, and denounced to every Body of the Ancient and Accepted Scottish Rite in the World as a traitor and forsworn; and may God aid me to keep and per- form the same. Amen. I hereby certify that I have read the above and subscribe thereto. ______Signature of Applicant

Have you ever held or expressed opinions contrary to the foregoing, or been affiliated with any organization which has? ______(If so, explain on the reverse side of this application.) Have you previously applied for the Scottish Rite Degrees? ______If so, when? ______

(Petition must be secured by Scottish Rite Masons in Good Standing) Petition secured by______(Name must be legible to receive credit) Address ______Fees: $ 175.00 Also vouched for by ______At least $80 must accompany Address ______this petition

Please do not send cash. We accept checks, VISA and Mastercard. To use your credit card, complete the following: Card No.______V Code_____ Exp. Date ______Total Amt to $______Mail to: Guthrie Scottish Rite Bodies, P.O. Box 70, Guthrie, Oklahoma 73044 (405) 282-1281 [email protected] 8/2013