Scottish Rite Petition

Valley of South West Georgia

Ancient & Accepted Scottish Rite of Freemasonry, S.J., U.S.A.

Petition for Membership
To the Officers & Members of the Valley of South West Georgia in the Orient of Georiga:

I am a Master Mason in good standing, and respectfully petition to receive the Fourth through Thirty-second degrees, promising to bear true faith and allegiance to the Supreme Council of the Thirty-thrid Degrees for the Southern Jurisdiction of the United States of America
Full Name*

First NameMiddle NameLast NameSuffix
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Masonic Information
Blue Lodge Information*

Blue Lodge Name

Blue Lodge Number

City or TownState

Postal / Zip Code
I was raised to the Sublime Degree of Master Mason in the year of:*
Have you passed your Master Mason's Catechism as required by your Grand Lodge?*

YesNo
Have you previously petitioned this or any other Scottish Rite body?*

YesNo

Recommending Masons & Valley Secretary
In order for your petition to be considered complete, you must be recommended by TWO Valley members in good standing OR by the Worshipful Master or the Secretary of your Blue Lodge.
Recommending Valley Member #1 *

First NameLast Name
Valley Member #1 Email*

Confirmation Emailexample@example.com
Recommending Valley Member #2*

First NameLast Name
Valley Member #2 Email*

Confirmation Emailexample@example.com

Sign and Submit
I accept the following fundamental principles as required by the Supreme Council of the Ancient & Accepted Scottish Rite, Southern Jurisdiction for the United States of America:
- The inculcation of patriotism, respect for law and order
- Underlying loyalty to the principles of civil & religious liberty
- The entire separation of church and state, as set forth in the Constitution of the United States of America
On my honor as a Master Mason, I attest the information on this petition is complete and accurate and that this petition is being made of my own free will and accord and without any hidden motives or agendas.
Signature*

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