DC Petition For Membership (with payment)

Petition for Membership

Ancient & Accepted Scottish Rite of Freemasonry, S.J., U.S.A.
To the Officers & Members of the Washington Valley in the Orient of the District of Columbia:

I am a Master Mason in good standing, and respectfully petition to receive the Fourth through Thirty-second degrees, promising to bear true faith and allegiance to The Supreme Council of the Thirty-third Degree for the Southern Jurisdiction of the United States of America.
Full Name

First NameMiddle NameLast NameSuffix
Preferred Name
Please click the arrows on the right and complete each section of the petition accurately and completely. To save and continue the form later, click the SAVE button at the bottom of the page. Once your petition is completed and submitted, it will be automatically sent to the Valley Secretary for further action.

Residence Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Is this your preferred mailing address?
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferred Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What type of number is this?
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What type of number is this?
Primary Email Address

Confirmation Emailexample@example.com
Secondary Email Address

Confirmation Emailexample@example.com

Blue Lodge Information

Lodge Name

Blue Lodge Number

City or TownState

Zip CodeCountry
I was raised to the Sublime Degree of Master Mason in the year:
Have you passed your Master Mason's Catechism as required by your Grand Lodge
Have you previously petitioned this or any other Scottish Rite body?
Please explain which body you petitioned and why you were not made a Scottish Rite Mason.

In order for your petition to be considered complete, you must be recommended by TWO Valley members in good standing in the Valley of Denver. List their names and emails below, and they will be notified automatically for confirmation.
Recommending Valley Member 1

First NameLast Name
Valley Member 1 Email

Confirmation Emailexample@example.com
Recommending Valley Member 2

First nameLast Name
Valley Member 2 Email

Confirmation Emailexample@example.com

The fee for initiation in the Washington Valley is $XXX.00 and covers you first year's dues, your reunion materials, A Bridge To Light text book, your 14° ring, and your Scottish Rite cap.
How would you prefer to pay your initiation fee?
Please Note: Your petition will not be considered complete until your check has been received. Please make your check in the amount of $360 payable to Denver Consistory.

Denver Consistory

1370 Grant St. Denver,

Co 80203-2347

Washington Valley Full Intitiation Fee Payment

Valley of Washington initiation Fee paid in full.

$360.00

Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

I accept the following fundamental principles as required by the Supreme Council of the Ancient & Accepted Scottish Rite, Southern Jurisdiction for the United States of America:
- The inculcation of patriotism, respect for law and order
- Underlying loyalty to the principles of civil & religious liberty
- The entire separation of church and state, as set forth in the Constitution of the United States of America.
On my honor as a Master Mason, I attest the information on this petition is complete and accurate and that this petition is being made of my own free will and accord and without any hidden motives or agendas.
Signature

Use your mouse to sign, or if you have a touch screen you can use your finger or stylus.
Please verify that you are human
Should be Empty:

Petition for Membership