Washington, 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 Valley of Washington, in the Orient of the District of Columbia

(D.C.Scottish Rite):

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 Director of Membership Services for further action.

Contact Information
Residence Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
State (Select from the dropdown)
Is this your preferred mailing address?*

YesNo
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
State (Select from the dropdown)
Preferred Phone Number*

Country CodeArea CodePhone Number
What type of number is this?*

HomeCellWork
Secondary Phone Number

Country CodeArea CodePhone Number
What type of number is this?

HomeCellWork
Primary Email Address*

Confirmation Emailexample@example.com
Secondary Email Address

Confirmation Emailexample@example.com

Personal Information
Birth Date*

MonthDayYear
Place of Birth*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you married?*

YesNo
Spouse Name

First NameLast Name
Occupation*
What is your employment status?
Last 4 Digits of your SSN*
Employer Information

Company Name

Street Address Line 2

CityState

Postal / Zip CodeCountry

Masonic Information
Blue Lodge Information*

Lodge Name

Blue Lodge Number

City or TownState

Zip CodeCountry
Please provide a photo of your current Blue Lodge dues card*
I was raised to the Sublime Degree of Master Mason in the year:*
Have you passed your Master Mason's Proficiency 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 Degrees (4°-32°) and membership in the Valley of Washington (DC Scottish Rite) is $495.00. A discounted fee of $395.00 is available only to active-duty United States military personnel. Payment of either fee includes first year’s membership dues, 14° gold ring, 32° black cap, 32° formal photo portrait, Morals & Dogma book, and Bridge to Light book.
The fee for petitioners specifically applying for membership in the AMSRB NATO Club and participation in the NATO Club’s Reunion in Italy is $265.00 (some exclusions may apply).
Please Select The Valley of Washington/DC Scottish Rite (also includes active-duty US military personnel) or the AMSRB NATO Club*

Washington/DC Scottish RiteAMSRB NATO Club
How would you prefer to pay your initiation fee?

Credit Card (preferred)Check
Please Note: Your petition will not be considered complete until your check has been received. Please make your check in the amount of either $495, $395 for Active-Duty U.S. Military, or $265 for AMSRB NATO Club members payable to D.C. Scottish Rite and mail to:

D.C. Scottish Rite
2800 16th Street, NW
Washington, DC 20009

Payment Options (Select Only One Option, please)*

Valley of The District of Columbia Full Initiation Fee Payment Product Image

Valley of The District of Columbia Full Initiation Fee PaymentValley of The District of Columbia initiation Fee paid in full.

$495.00

Valley of The District of Columbia Full Initiation Fee Payment/Active-Duty U.S. Military Product Image

Valley of The District of Columbia Full Initiation Fee Payment/Active-Duty U.S. MilitaryValley of The District of Columbia Initiation fee paid in full/Active-Duty U.S. Military

$395.00

Valley of the District of Columbia Full Initiation Fee Payment/AMSRB NATO Club members Product Image

Valley of the District of Columbia Full Initiation Fee Payment/AMSRB NATO Club membersValley of The District of Columbia Initiation fee paid in full/AMSRB NATO Club members

$265.00

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:

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.
Do you wholeheartedly approve of the inculcation of patriotism, respect for law and order, undying loyalty to the principles of civic and religious liberty, separation of church and state and protection of and respect for all individual rights as set forth in the Constitution of the United States of America?*

YesNo
Signature*

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Petition for Membership