PETITION
To the Worshipful Master, Wardens, and Brethren of GiIkey Lodge # 101, N.H.      

                        I,  …..................................................................................
                                                                                                  (Name In Full) 

a resident of ……………………………………………………….
                                                                                                      (Street)

              ….…………………………………………..   ……………
                                   (Town or City)                                      (State)                                         (Zip)                                (Phone)

 hereby voluntarily off myself as a Candidate for the mysteries of Freemasonry. I declare upon my
 honor that I am not influenced by mercenary or unworthy motives, being prompted by a
 favorable opinion of the Institution and a sincere wish to be serviceable to my fellow creatures.
              I promise, if accepted, a cheerful obedience to the By-laws of your lodge. To the requirements of the M. W. Grand Lodge, and to the ancient usages of the craft.  

              I was born in the town of ……………………………………. in the state of ………………..

     On the………………. day of ……………… ,A. D. 19…………

   I am by occupation a………………………………………………………………………………

 I have... . . . . .. applied to any other Lodge for the degrees of Masonry, in this or any other jurisdiction.
                    
                                                                        

                                                                                           ..........................................................
                                                                                                                                                                            (Sign Full Name)

           We, members of Gilkey Lodge # 101 are personally acquainted with the above applicant, and from a confidence in his integrity, and the uprightness of his intentions, recommend and propose him as a proper Candidate for the mysteries of Freemasonry.  

 

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Note: The name of the applicant must be given in full, including the middle name. The full fee must accompany the application.
The applicant must have resided in the State of NH for at least twelve months next preceding the date of this application. If he resides outside the State of NH, a Waiver of jurisdiction must first be obtained before action can be taken on his petition. The petition must be signed by at least two members of the Lodge.