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PETITION FOR
INITIATION AND MEMBERSHIP
OASIS SHRINERS,
A.A.O.N.M.S.
To: The Illustrious
Potentate, Officers, and Nobles of Oasis Shriners, situated in the Oasis
of Charlotte, Desert of North Carolina:
I, the undersigned, hereby declare that I am a Master Mason
in good standing in:
_____________________________________
Lodge No.___________A. F. & A. M.
Located
At:_________________________________________________________________________________
Number & Street
~ City/Town
~ State
~ Zipcode
Lodge recognized by or in amity with the Conference of
Grand Masters of North America. Furthermore,
I have resided at my current address for not less than 6 months, as
required by the By-Laws of the Imperial Council.
I respectfully pray that I may be made a Noble of the Mystic
Shrine, and become a member of your Shrine Chapter
If
I be found worthy, and my request granted, I promise to conform to the
Articles of Incorporation and By-Laws of the Imperial Council and the
By-Laws and Ceremonies of your chapter.
Birthplace:
_______________________________________
Date of Birth:
__________________
Were you ever a DeMolay? ____________
If so, what chapter name & location? ____________________
Profession/Occupation:
_________________________________________________________________
Have you previously applied for admission to any Shrine chapter of the
Order? _________________________
If
so, where?
_________________________________
When?
_________________________________
Residence:
____________________________________________________________________________________
Number & Street
~ City/Town
~ State
~ Zipcode
Mailing
Address_________________________________________________________________________________
Number & Street
~ City/Town
~ State
~ Zipcode
Business
Address______________________________________________________________________________
Number & Street
~ City/Town
~ State
~ Zipcode
Telephone______________________________________________________________________________
Home Phone
Number
~ Business
Phone Number
Email
Address: ________________________________________________________________________
Spouse's
Name: ____________________________Your
Hat Size:________________________________
PRINT YOUR
FULL NAME HERE: ____________________________________________________________________
Date of this
Petition:
_________________
Your Signature: ______________________________
This candidate recommended and vouched for on the honor of:
Noble
__________________________________ Shrine # ___________ Club/Unit
___________________
Noble
__________________________________ Shrine # ___________ Club/Unit
___________________
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(Attach
to the petition a check or money order for $200.00.
This payment includes current year’s dues, your Oasis Fez and
lapel pin.)
FOR
CREDIT CARD PAYMENT: Card
Type: _________________________________ (MC, VISA, DISCOVER)
CARD
# ____________________________________________________ EXPIRATION DATE:
___________
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