New Bern, North Carolina Petition For Membership (with payment)

New Bern Petition for Membership

Ancient & Accepted Scottish Rite of Freemasonry, S.J., U.S.A.
To the Officers & Members of the Valley of New Bern
in the Orient of North Carolina:

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
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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.

Masonic Information
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*

YesNo
Have you previously petitioned this or any other Scottish Rite body?*

YesNo
Please explain which body you petitioned and why you were not made a Scottish Rite Mason.

Recommending Masons & Valley Secretary
In order for your petition to be considered complete, you must be recommended by TWO Valley members in good standing.
Recommending Valley Member 1*

First NameLast Name
Valley Member 1 Email*

Confirmation Email
Recommending Valley Member 2*

First NameLast Name
Valley Member 2 Email*

Confirmation Emailexample@example.com

Initiation Fee
The fee for initiation in the Valley of New Bern is $200.00 and covers your first year's dues, your reunion materials and 14th Degree Ring.
Please make your check payable to:

Scottish Rite Valley of New Bern

Mail Checks to:

Scottish Rite Valley of New Bern
2100-A S. Glenburnie Rd
New Bern, NC 28562

NOTE: Your petition is not considered complete until your check has been recieved.

Credit Card Payment *

Valley of New Bern Full Initiation Fee PaymentValley of New Bern initiation Fee paid in full.

$200.00

Total

$0.00

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

Sign & Submit
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*

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New Bern Petition for Membership