PROCLAMATION No.2 - Prince Hall Grand Masonic Lodge of ...

DEBORAH GRAND CHAPTER
Order of Eastern Star
Prince Hall Affiliation
Commonwealth of Pennsylvania
Return To:
Ruth C. Knox
Deborah Grand Chapter
Convention Committee
3836 Germantown Avenue - A
Philadelphia, PA 19140
(215) 225-3336
Deadline: June 30,2010
Pre-Registration Fee: $40.00
On Site Fee: $45.00 (CASH ONLY)
Make All Checks Payable To:
Deborah Grand Chapter
Convention Committee
94thANNUAL GRAND SESSION
REGISTRATION FORM
Name Of Chapter: _ No.: _
NAME WM WP AM AP PWM PWP PGWM PGWP Grand Officer Title Fee Paid
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Name Of Secretary:
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Phone#:
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Total Registered:
Total Amount Enclosed:
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Date Received:
_ Members:
Fees Paid:
Registrar:
_____ Check #:
OFFICIAL USE ONLY
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Bank#:
Gratis: Total: _
_ Receipt #
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