Your Full Name:
_______________________________________________________________
Address:
_____________________________________________________________________
City, State, Zip:
________________________________________________________________
Date of Birth:___/___/___
Place of Birth: __________________________________________
Occupation:
___________________________________________________________________
Employer:
____________________________________________________________________
Home Phone: (_____) ___________________ Business Phone: (_____)____________
Blue Lodge Name:______________________________________________ No. ______
Date Raised: ___________________________
Your Lady’s Name: _____________________
I have resided in California for _____ years.
I have never applied for any of the Scottish Rite Degrees and I now respectfully petition to
receive the Degrees from the 4th to the 32nd inclusive, promising always to bear true faith
and allegiance to the Supreme Council of the Thirty-third Degree, for the Southern
Jurisdiction of the United States.
1. The Supreme Council announces as fundamental principles the following:
“The inculcation of patriotism, respect for law and order and undying loyalty
to the constitution of the United States of America.”
“The entire separation of church and state and opposition to every attempt
to appropriate public monies—Federal, State and local—directly or indirectly,
for the support of sectarian or private institutions.”
Do you approve wholeheartedly of these principles?
_________________________________
2. Have you ever held or expressed opinions contrary to the foregoing or been affiliated
with any organization which has? If you answer this question in the affirmative, give
particulars on a separate sheet of paper.
_________________________________________________
Recommended By:
___________________________________
____________________________________
Petitioner’s Usual Signature:___________________________________
Dated: _________________________ , 20___
Fall Class (Degrees 4°–32° inclusive): $200, plus $95 for 2008 Dues.
Total Fees & Dues: $295.00.
Please make remittance payable to: SACRAMENTO SCOTTISH RITE BODIES.
Check appropriate box if you wish to use your credit card: ❏ Visa ❏ MasterCard
Card No: ____________________________________________
Expiration Date: _____ / _____
MAIL TO: Sacramento Scottish Rite, PO Box 19497, Sacramento, CA 95819
_______________________________________________________________
Address:
_____________________________________________________________________
City, State, Zip:
________________________________________________________________
Date of Birth:___/___/___
Place of Birth: __________________________________________
Occupation:
___________________________________________________________________
Employer:
____________________________________________________________________
Home Phone: (_____) ___________________ Business Phone: (_____)____________
Blue Lodge Name:______________________________________________ No. ______
Date Raised: ___________________________
Your Lady’s Name: _____________________
I have resided in California for _____ years.
I have never applied for any of the Scottish Rite Degrees and I now respectfully petition to
receive the Degrees from the 4th to the 32nd inclusive, promising always to bear true faith
and allegiance to the Supreme Council of the Thirty-third Degree, for the Southern
Jurisdiction of the United States.
1. The Supreme Council announces as fundamental principles the following:
“The inculcation of patriotism, respect for law and order and undying loyalty
to the constitution of the United States of America.”
“The entire separation of church and state and opposition to every attempt
to appropriate public monies—Federal, State and local—directly or indirectly,
for the support of sectarian or private institutions.”
Do you approve wholeheartedly of these principles?
_________________________________
2. Have you ever held or expressed opinions contrary to the foregoing or been affiliated
with any organization which has? If you answer this question in the affirmative, give
particulars on a separate sheet of paper.
_________________________________________________
Recommended By:
___________________________________
____________________________________
Petitioner’s Usual Signature:___________________________________
Dated: _________________________ , 20___
Fall Class (Degrees 4°–32° inclusive): $200, plus $95 for 2008 Dues.
Total Fees & Dues: $295.00.
Please make remittance payable to: SACRAMENTO SCOTTISH RITE BODIES.
Check appropriate box if you wish to use your credit card: ❏ Visa ❏ MasterCard
Card No: ____________________________________________
Expiration Date: _____ / _____
MAIL TO: Sacramento Scottish Rite, PO Box 19497, Sacramento, CA 95819
Ancient and Accepted Scottish Rite of Freemasonry Southern Jurisdiction, Orient of California,Valley of Sacramento, |
