The Most Worshipful United Grand Lodge of Ancient, Free and Accepted Masons of Democratic Republics Application for Membership and/or Petition for the Degrees of Freemasonry APPLICANT - PLEASE READ BELOW AND THE REVERSE SIDE BEFORE COMPLETING THIS FORM As the exact nature of the Institution of Freemasonry as practiced by this Grand Lodge may be unknown to you, it is therefore deemed advisable that before you sign this application you should be informed on certain phases of this institution which may effect your decision to apply for membership therein n to wit: (1)The Grand Lodge and its subordinate lodges are erected to God and dedicated to the patriarchs (2)Freemasonry has in all ages required that men come to its doors of their own free will and accord; not as a result of importunity nor from feelings of curiosity; but from a favorable opinion of the institution, a desire for knowledge, and a sincerely wish to be of service to their fellow creatures.(3) Freemasonry is not a religion, political or Grand Lodge Petition for Degrees

The Most Worshipful United Grand Lodge of Ancient, Free and Accepted Masons of Democratic Republics

Application for Membership and/or Petition for the Degrees of Freemasonry

APPLICANT - PLEASE READ BELOW AND THE REVERSE SIDE BEFORE COMPLETING THIS FORM

As the exact nature of the Institution of Freemasonry as practiced by this Grand Lodge may be unknown to you, it is therefore deemed advisable that before you sign this application you should be informed on certain phases of this institution which may effect your decision to apply for membership therein n to wit: (1)The Grand Lodge and its subordinate lodges are erected to God and dedicated to the patriarchs (2)Freemasonry has in all ages required that men come to its doors of their own free will and accord; not as a result of importunity nor from feelings of curiosity; but from a favorable opinion of the institution, a desire for knowledge, and a sincerely wish to be of service to their fellow creatures.(3) Freemasonry is not a religion, political organization, or a social club and does not intrude into the affairs of these groups as it has for its foundation the belief in the fatherhood of God, the Brotherhood of man, and the immortality of the soul subordinate to a supreme being, with the Law (Holy Bible) being his inestimable gift to man and that the LAW should be the rule and guide for mans' faith and transactions with mankind. (4)I t is a brotherhood pledged to the building of character. (5) Thoughts, words, motives, and deeds are the substance used to achieve these goals. (5)It inculcates the practice of virtue and uses biblical allegories in its teachings. (6)The Institution is not an insurance society nor does it pay benefits in case of sickness or death. (7)It is an educational and charitable institution and it extends such assistance as it is willing and able to grant. (8)It knowingly admits none to membership except those who are able to provide for themselves and those dependant on them.



To the Worshipful Master, Wardens and members of



I Am Lodge No. ONE holden under the Most Worshipful United Grand Lodge of Ancient, Free, and Accepted Masons of Democratic Republics, City of Virginia Beach,_ State of Virginia, of the Democratic Republic of The United States of America I have resided for the past twelve month within your jurisdiction and beg leave to state that I believe in God as the Supreme Architect and Governor of the Universe, and unbiased by friends and uninfluenced by mercenary motives, freely and voluntary offer myself as a member and/or a candidate for the degree(s) of Masonry - which ever is applicable under the jurisdiction of the Most Worshipful United Grand Lodge of Ancient, Free, and Accepted Masons of Democratic Republics and that I am prompted to seek this empowerment by a favorable opinion conceived of the Grand Lodge, a desire for knowledge and a sincere wish of being serviceable to my fellow creatures. Should this petition be granted, I will cheerfully conform to all the established customs and usages of the Grand Lodge and the Fraternity of Freemasonry.

Please Print or Type

Name in Full: First

Middle

Last





Residence / Street/etc.

NO.

County/Providence/etc.

City/State/etc.

Democratic Republic





Where Born/ Place

City/State/Country/etc.

Date of Birth

Father's Name

Mother's Maiden Name

Your Occupation





Social Security Number

Home Phone Number with Area Code, etc.

Work Phone Number with Area Code, etc.





I am: Single

Married

Widower

Divorced

Wife's Maiden Name





Dependant's Full Name

Age/Date of Birth

Relationship









Describe your physical defects and deformities if any:

For the Past Ten Years Please Give

Name of Employer

Address

City/State/etc.

Occupation

Length of Employment







Home Address/City/ State/ Etc.

Year From

Year To





Please give, if you are already a Mason the following information

Lodge Name

NO

Grand Lodge of

Degree EA/FC/MM Received

Date Received







I have read the information herein contained on the front and back of this application and state, on my honor, that the statements and answers are true and further sate that I answered all the questions and have never been charged in a court of law with a criminal offense.

Sign full legal name in own handwriting

I usually sign my name thus

Date

Fee Accompanying this application

$1,000.00



Below is for Lodge use only





Petition for Degrees of/Name in Full


Application Received

Elected

Initiated

Passed

Raised







RECOMMENDERS (VOUCHERS) PLEASE FILL IN BELOW



We/I hereby certify that I have known the petitioner for a period of one year and am well acquainted with the applicant and have read this application and believe the applicant has answered the questions truthfully and each of us believe the applicant to be morally and physically qualified, of good character and under the tongue of good repute. Accordingly we cheerfully recommend him as a proper candidate for membership.



Name (Please Print)

Signature





Address/Street

NO

City/County

State/Providence

Democratic Republic





Lodge Name

NO

Location





WORK TELEPHONE NO. WITH AREA CODE

HOME TELEPHONE NO. WITH AREA CODE









Name (Please Print)

Signature





Address/Street

NO

City/County

State/Providence

Democratic Republic





Lodge Name

NO

Location





WORK TELEPHONE NO. WITH AREA CODE

HOME TELEPHONE NO. WITH AREA CODE









To the Most Worshipful Grand Master, Deputy Grand Master, Grand Wardens and Members of the Most Worshipful United Grand Lodge of Ancient, Free and Accepted Masons of Democratic Republics, we, the Worship Master, Wardens and Members of ______________________________ Lodge No. _________ of the City of ________________, of the County/Providence of ____________________, State of ___________, of the Democratic Republic of _________________________ holden under you - forward this application for you approval with the recommendations and endorsements as hereon shown.

Attest: Secretary Lodge Seal to Be Affixed Attest: Worshipful Master






Grand Lodge Action: Approved/Denied

Attest: By/Title/Date









Waiver of Election and/or Vouchers and/or Fees By

David Martin Lindsey

Grand Master of Masons

of The Most Worshipful United Grand Lodge of Ancient Free and Accepted Masons of Democratic Republics

Date







Date









Attest: Grand Secretary

West Gate

E-Mail

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