The Masonic Kilties of New Jersey APPLICATION  for  MEMBERSHIP

                                                                          Date of Application:  ___  / ___  / _____

I, the undersigned, a Master Mason and a member in good standing of ____________________________ Lodge # ______, F. & A. M., located at ____________________________ under the jurisdiction of the Grand Lodge of ____________________________ hereby make application for membership.

If accepted, I agree to conform to the BY-LAWS and all REGULATIONS of the ASSOCIATION, now in force or which may hereafter be adopted.  I understand that if I do not own a Kilt, or acquire one within six months of being elected, or if I do not attend at least one (1) Visitation or Regular Communication during each Calendar Year, unless explicitly excused by the President, my membership may be forfeited.  I further understand that in the event my membership is forfeited for any reason, all fees paid, including Membership Fees, Annual Dues and Life Dues, are NOT refundable.

____________________________________________      ____________________________________________

(Sign your name in full)                                             (E-mail address, if any)

____________________________________________      ____________________________________________

(Print your name in full)                                             (Print your wife's name)

____________________________________________      ____________________________________________

(Print your street address in full)                             (Print city, state, & zip in full)

_________________________                            ___  / ___  / _____           ___________

(Home telephone number)                             (Date of birth)                        (Year raised to MM°)

If a Past Master, Lodge(s) and year(s) served:       ___________________________________

Highest Grand Lodge Office held, if any:    _________________  year(s) served:    _______

Do you own Kilts?  Yes/No     Do you play the PIPES?  Yes/No     or DRUMS?  Yes/No

Proposed by: __________________________    Seconded by: __________________________

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A Membership Fee of $5.00 MUST accompany this application, plus Dues ($2.00 per year) for at least the current year.  You may pay as many years in advance as you wish.  Life Membership is available, for a one-time fee of $55.00 (includes $5.00 Membership Fee plus $50.00 Life Dues).

PLEASE RETURN TO:    Frederick I Waldron, 124 Liberty Street,  Lodi,  NJ  07644.

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Received:  ___ / ___ / _____     Elected:  ___ / ___ / _____     Dues Card Issued:  ___ / ___ / __