Staffs & Shrops Provincial Grand Conclave 2026

The Order of the Secret Monitor
Province of Staffordshire and Shropshire

Booking for the Provincial Grand Conclave to be held on Saturday 26th September 2026 at
The Masonic Hall, Ashfield House, 218 Ashby Road, Burton-on-Trent DE15 0LA

Please respond at least two weeks before the meeting to ensure accomodation at the festive board

Your Name

PrefixFirst NameLast Name

Name of your OSM Province

Your Provincial Office

Your Grand Rank

Your Email

example@example.com

Your Attendance Status

Your meal type

Please note Special Dietary Requirements (Self)

Wife/Partner Name

PrefixFirst NameLast Name

Wife/Partner meal type

How Many Guests?

Please note Special Dietary Requirements (Wife Partner)

Guest One Name

PrefixFirst NameLast Name

Guest One OSM Province

Guest One Provincial Office

Guest One Grand Rank

Guest One Meal type

Please note Special Dietary Requirements (Guest one)

Guest Two Name

PrefixFirst NameLast Name

Guest Two OSM Province

Guest Two Provincial Office

Guest Two Grand Rank

Guest Two Meal type

Please note Special Dietary Requirements (Guest two)

Guest Three Name

PrefixFirst NameLast Name

Guest Three OSM Province

Guest Three Provincial Office

Guest Three Grand Rank

Guest Three Meal type

Please note Special Dietary Requirements (Guest three)

Guest Four Name

PrefixFirst NameLast Name

Guest Four OSM Province

Guest Four Provincial Office

Guest Four Grand Rank

Guest Four Meal type

Please note Special Dietary Requirements (Guest four)

Guest Five Name

PrefixFirst NameLast Name

Guest Five OSM Province

Guest Five Provincial Office

Guest Five Grand Rank

Guest Five Meal type

Please note Special Dietary Requirements (Guest five)

Cost of the meal per person (including wine)

Number Dining

Total Cost

Please remember ordered meals must be paid for even if not taken

Notes

Please add any notes you may have for the Provincial Grand Recorder