Knights Templar Subordinate Commandery’s of James Moss Prince Hall Grand Commandery Knights Templar of Indiana:
The undersigned represents that he received the degree of Master Mason in
); in jurisdiction requiring the Cryptic Degrees as
); that he is a firm believer in the Christian religion, and that he has not
petitioned any other Commandery; (or, that he petitioned
); that for the year immediately prior to the date of this
(or, in the case of Subordinate Commanderies, of the Grand Encampment of Knights Templar of the United States of
; that he is desirous of receiving the Orders of Knighthood conferred in your
Commandery , and if found worthy, promises to conform to the ancient usages and customs of the Order.
He has read this petition and signs his full name there to.