INITIATION FEE $______Petition for Chivalric Orders
To the Eminent Commander and Sir Knights of ______Commandery No. ______, Knights Templar of California: The undersigned respectfully represents that he is a member in good standing of ______Lodge No. ______, F. & A. M., under the jurisdiction of the Grand Lodge of ______; that he is a member in good standing of or has petitioned to receive the Capitular Degrees in ______Chapter No. ______, R. A. M., under the jurisdiction of the Grand Chapter of ______; that he is a member in good standing of or has petitioned to receive the Cryptic Degrees in ______Council No. ______, C. M., under the jurisdiction of the Grand Council of ______; that he desires to receive the Orders of Knighthood; that he is a firm believer in the Christian religion; that he has been a resident of the State of California for six months next preceding the date of this petition; that he has not, within six months past, made application to and been rejected by any Commandery of Knights Templar;* and that he promises, if found worthy, to conform to all usages, customs, laws and regulations of the above named Commandery and the Grand Commandery of Knights Templar of the State of California. ______* If such application has been made, state the name and location of the Commandery on the line above.
Place of Birth: ______
Date of Birth: ______
Occupation: ______
Residence Address: ______City: ______State: _____ Zip+4: ______
Residence Phone: ______
Business Address: ______City: ______State: _____ Zip+4: ______
Business Phone: ______Print Name: ______First Name Middle Name Last Name Dated: ______Signature: ______
4444444444444444444444444444444444444444444444 4444444444444444444444444444444444444444444444 RECOMMENDED BY: REFERS TO: Sir Knight ______Name: ______
Address: ______Address: ______City: ______Phone: ______City: ______Phone: ______
Sir Knight ______Name: ______Address: ______Address: ______
City: ______Phone: ______City: ______Phone: ______4444444444444444444444444444444444444444444444 4444444444444444444444444444444444444444444444
Elected: ______Knight of Malta: ______
Red Cross: ______Knight Templar: ______