Most Worshipful Grand Master
**$20 application fee (non-refundable) must accompany application is rendered incomplete. / Ill. Brandon Bolden
Grand Secretary
$120 Affiliation fee
PETITION FOR THE SYMBOLIC DEGREES OF MASONRY
SUNSET GRAND LODGE A.F. & A.M.
JURISDICTION OF TEXAS, INC.
To the Worshipful Master, Wardens, and brethren of
Eureka Lodge No. 96 A.F. & A.M. of Houston, Texas:
The undersigned respectfully represents that he freely and voluntarily offers himself as a candidate for the mysteries of Masonry; that he chose to solicit this privilege by a favorable opinion conceived of the institution, a desire for knowledge, and a sincere wish to be serviceable to his fellow man, and that he promises, if found worthy, to conform to all the ancient usages and regulations of the Fraternity.
What is your full name?What is your age? / Date of Birth / //
Father’s Name / Mother’s Name
Place of Birth: / City / County / State
Where do you reside? (Full Address)
Home Phone / () - / Cell Phone / () -
Emergency Contact / Emergency Number / () -
Employer / Occupation
Employer Address
Are you married or single? / -Select-MarriedSingle / Have you ever been divorced? / -Select-YesNo
How long have you resided in the State of Texas?
What is your religion? / Do you believe in the existence of a Supreme Being? / -Select-YesNo
Have you ever been convicted of a crime in any court? / -Select-YesNo
If yes, state the court in which sentence passed, and whether sentence was served:
Have you ever served in the Armed Forces of the USA? / -Select-YesNo
If yes, give the particulars including type of discharge
Have you ever petitioned a Masonic Lodge before? / -Select-YesNo
If yes, give the Lodge Name, Number and Location
Have you read all the questions contained in the foregoing application? / -Select-YesNo
Are all your answers thereto in your own handwriting? / -Select-YesNo
Do you upon your honor declare your foregoing statements to be true? / -Select-YesNo
I’m signing my name in my own handwriting this / day of
Signature of Petitioner*
Worshipful Master
Lodge Secretary
*Typing your name here serves as an electronic signature.
**Application fee must accompany application or application will not be considered.