James W Moss P.H. Grand Commandery, KT Petition the Orders

KT Petitioners Name

First Name Last Name

To the Eminent Commander, Generalissimo, Captain General and Sir Knights of

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

, under the jurisdiction of the Most Worshipful Prince Hall Grand Lodge of

that he is at the present time a member of Lodge (Name) *

Choose the lodge you're in

under the Jurisdiction of the Most Worshipful Prince Hall Grand Lodge of

_, under the jurisdiction of the St. Andrew Grand Chapter HRAM of

and that he is at present time a member of Royal Arch Chapter

Only choose a Chapter if you are a Royal Arch Mason

under the jurisdiction of the Grand Chapter of

or that he has petitioned the Royal Arch Chapter below

Choose a HRAM Chapter here if you're not already Royal Arch Mason

, Royal Arch Masons, under the jurisdictions of the Grand Chapter of

for the Capitular Degrees and that he will be affiliated with *

under the jurisdiction of the St. Andrew HRAM Grand Chapter of

); in jurisdiction requiring the Cryptic Degrees as

prerequisite to the Orders of Knighthood, that he received the degrees of Select Master in Royal and Select Council *

R&SM Council Name

, under the jurisdiction of the Alan W. White, Sr. Prince Hall Grand Council, Royal & Select Masters of

and that he is at present time a member of *

R&SM Council Name

, under the jurisdiction of the Alan W. White, Sr. Prince Hall Grand Council, Royal & Select Masters of

Enter Grand Council Name Here

; or, that he has petitioned *

R&SM Council Name

Royal and Select Masters, under the jurisdiction of the Alan W. White, Sr. Prince Hall Grand Council, Royal & Select Masters of

Enter Grand Council Name Here

for the Cryptic Degrees and that he will be affiliated with *

R&SM Council Name

under the jurisdiction of the Alan W. White, Sr. Prince Hall Grand Council, Royal & Select Masters of

Enter Grand Council Name Here

); that he is a firm believer in the Christian religion, and that he has not

petitioned any other Commandery; (or, that he petitioned

Commandery

Enter Name of Commandery Here

, on

Enter date here MM/DD/YYYY

, and that he was

(elected or rejected)

); that for the year immediately prior to the date of this

petition he has resided within the jurisdiction of the Grand Commandery of Knights Templar of

Enter the name of the State

(or, in the case of Subordinate Commanderies, of the Grand Encampment of Knights Templar of the United States of

America and for the latter half of that year within the jurisdiction of *

KT Commandery Name

of

Enter Name of Grand Commandery

; 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 was born on the *

Enter Day Born (ex. DD)

day of *

Enter Month Born (ex. MM)

A.D. *

Enter Year Born (ex. YYYY)

_, in the State of *

, His place of residence is *

Enter Current Address

, His occupation is that of *

Phone No. *

, Last 4 numbers of Social Security No.

Email *

example@example.com

Hat Size

i.e. 7, 71/4, 7 1/8, 7 1/2. etc....

Beneficiary Name

, Beneficiary Relation

He has read this petition and signs his full name there to.

(sign) *

By typing my name above I agree to the signature being placed on the form.

Dated *

Date

1st Voucher Email Address

example@example.com

We vouch for the good character and Masonic standing of the petitioner and recommend his admission. Type your Name

By typing my name above I agree to the signature being placed on the form.

2nd Voucher Email Address

example@example.com

We vouch for the good character and Masonic standing of the petitioner and recommend his admission. Type your Name

By typing my name above I agree to the signature being placed on the form.

James W Moss PH Grand Commandery, KT Petition