Petition for Initiation and Membership, Nobles Of the Mystic Shrine, Ararat Temple, with Additional Notes
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OCR Page 1 of 3No.
PETITION FOR INITIATION AND MEMBERSHIP
ANCIENT ARABIC ORDER
NOBLES OF THE MYSTIC SHRINE
ARARAT TEMPLE
TO THE ILLUSTRIOUS POTENTATE, OFFICERS AND MEMBERS OF
ARARAT TEMPLE, SITUATED IN THE OASIS OF KANSAS CITY, DESERT
OF MISSOURI:
I, the undersigned, hereby declare that I am a Knight Templar in grood standing in
Commandery No.
situated at
State of
a 32-degree
A. & A. Scottish Rite Mason, in good standing in the Valley of
Consistory of
Furthermore, I do not now, and never will, hold membership in or allegiance to, any body claiming to be Masonic that has
been declared clandestine by the Supreme Council 33° for the Northern or Southern Jurisdiction of the United States of America:
that I have resided within the jurisdiction of your Temple, or in unoccupied territory, not less than six months, as required by the
Constitution of the Imperial Council, and that I am not under suspension or expulsion in either of the bodies prerequisite to this
Order, and respectfully pray that I may be made a Noble of the Mystic Shrine, and become a member of your Temple.
I furthermore represent that I have never previously applied for said order, nor have I, to my knowledge been rejected by
any other Temple.
If I be found worthy, and my request granted, I promise to conform to all the Ceremonies, Engagements, Constitutions,
Regulations and Edicts of the Imperial Council; together with those of your Temple.
Birthplace
Date of birth
day
month
year
Profession or occupation
Residence; No.
Street, City
Business or P. O. Address: No.
Street, City
Date
191 Send mail to
Business or
Residence
Address
Blue Lodge Membership
Novice
Signature [full name]
Recommended and Vouched for on the Honor of
Noble
Noble
SIGN FULL NAME
Print Full Name Also on Margin
The Fee of Seventy-five Dollars Inclosed. Make Check Payable to the Recorder
TO THE ILLUSTRIOUS POTENTATE, OFFICERS AND NOBLES
Fee ($75.00) paid
OF ARARAT TEMPLE, A. A. o. N. M. S.:
Filed
The committee appointed on the within petition to make necessary inquiries rela-
tive to petitioner, have performed their duty and beg leave to report
favorable
Elected
of the prayer of the petition being granted.
Created
Committee.
01 anaa
Terms
विषय
World War, 1914-1918
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