Special Chapter Petition

PETITION FOR SPECIAL CONFERRAL

DEGREES OF MARK MASTER AND PAST MASTER
To the Grand Chapter of Royal Arch Masons of the State of Missouri

I, the undersigned, being a Master Mason in Good Standing in the Lodge noted below under the jurisdiction of the Grand Lodge of Missouri, having been personally invited by the Grand Master of the Grand Lodge A. F. & A. M. of Missouri and the Grand High Priest of the Grand Chapter of Royal Arch Masons of the State of Missouri, certify that I have resided within the jurisdiction for the past twelve months, and do respectfully petition for the Degrees of Mark Master and Past Master.
Lodge Name*
Lodge Number*
Lodge City*
Lodge State*
Missouri Member ID*
I, the undersigned, promise always to conform cheerfully and strictly to all by-laws, rules and regulations of the state and local bodies of the Grand Lodge of Ancient, Free and Accepted Masons of the State of Missouri and the Grand Chapter of Royal Arch Masons of the State of Missouri.
Signature in full*

Clear
Invited by:

M.:W.:.B.:. Kevin M. Fuller, Grand Master
M.:.E.:.C.:. Michael L. Dodd, Grand High Priest
If the applicant has previously applied for any of the degrees of Royal Arch Freemasonry, he will explain fully here, giving all particulars relating thereto.
PETITIONER MUST GIVE DETAILED INFORMATION BELOW
Name*

First NameFull Middle Name (No Initials)Last Name
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Occupation*
If Retired, enter Occupation you Retired From
Business Name
Enter Business Name you currently work for or Retired From
Business Address

Street Address

Street Address Line 2

CityState

Zip Code
Home Number
Cell Number
Birth Date*

MonthDayYear
Email Address*
Place of Birth*
City, ST
Spouse Name
If, after having received the Special Conferral of the Degrees of Mark Master and Past Master, should the petitioner desire to proceed to full membership in a Chapter of Royal Arch Masons, please complete a standard petition for the Chapter Degrees and submit to the Secretary or any member of a Chapter in or near you.
Should be Empty:

PETITION FOR SPECIAL CONFERRAL

PETITIONER MUST GIVE DETAILED INFORMATION BELOW