Membership Application

would be delighted to welcome you as a new member. Membership application is easy. Complete the application form below and submit your details and someone will reply to you as soon as possible.

Your Name

Your Address

Date of Birth (dd/mm/yy)

Landline/Mobile

Your Occupation

Current Employer (Name and Address)

Have you ever been proposed for membership in any Lodge, or has your admission to any Lodge ever been sought either by yourself or by anyone on your behalf?

Yes

Do you believe in God or a Supreme Being?

Yes

Are you prepared to take an obligation on the Bible or the Book of your faith?

Yes

Do you have a criminal record, or any impending court cases?

Yes

Details of criminal convictions If you answered \'yes\' to the above question, please provide details of any criminal convictions or impending court cases.

Do you know any other Freemasons?

Yes

Does your partner support your move to join a Masonic Lodge?

Yes

No Partner

Please state below briefly why you wish to become a Freemason. It would be useful to know if you have family or other connections with Freemasonry, what you hope to gain and what you feel you can perhaps contribute should you become a member.

By returning this form, I agree for you to use the information I have provided above with a view to my becoming a Freemason.

Agree

For security verification, please enter any random two digit number. For example: 62

Scarsdale Lodge 681

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