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.