PETITION FOR AFFILIATION - Grand Lodge of Colorado

PETITION FOR AFFILIATION
(As An Entered Apprentice or Fellow Craft)
To the Worshipful Master, Wardens, and Brethren of _______________________________Lodge
No. _________, Ancient Free and Accepted Masons:
The petition of the subscriber respectfully represents that he was initiated an Entered Apprentice
on the _______ day of ______________________________________, _______, (and Passed to the degree of a
Fellow Craft on the _______ day of __________________________, ________,) in _______________________
Lodge No. ___________, A.F. & A.M., held at _____________________________________, under the
jurisdiction of the Grand Lodge of ________________________________, which Lodge has granted a
Dimit, or Waiver of Jurisdiction, properly assigned by the Secretary of the Lodge, and the Grand
Secretary of the Grand Lodge of ___________________________, and which accompanies this petition; and
he now prays to be affiliated with your Lodge as an Entered Apprentice (Fellow Craft), and to receive the
degrees of Fellow Craft and Master Mason (degree of Master Mason) and become a member of your
Lodge, if found worthy. If accepted, he promises a strict conformity to the ancient usages and customs of
the institution, and pledges himself to a cheerful obedience to the By-laws of your Lodge and to the
established rules and regulations of the fraternity.
(Questions to be answered in writing by the petitioner.)
Where were you born? _______________________________________________________
When were you born? ________________________________________________________
What is your occupation? _____________________________________________________
Where do you reside? ________________________________________________________
How long have you lived in Colorado? __________________
What has been your place of residence the past year? _____________________________
______________________________________________________________________
Do you believe in the existence of one ever-living and true God? __________
Do you know of any physical, legal, or moral reason which should prevent you from becoming a Freemason?
______________
Have you in the past violated, or are you now violating, the criminal law of any state or country in which
you have resided or in which you are now residing? _____________
Do you promise not to violate such law in the future? ______________
From what Lodge did you withdraw? _____________________________ Lodge No. _________
Located at _________________________________________________________
Dated at ____________________________, Colorado this ________ day of _________________, 20 _______.
Recommended by:
_________________________________
_________________________________
Members of the Lodge and Fraternity who have known
the petitioner for at least 90 days, one of whom must be
a member of this Lodge.
X_________________________________________
(Name in full.)
Post Office address:
______________________________
______________________________
Form 26 (168) Rev. 2001

This Side to be Filled Out by the Secretary
Lodge No.
Ancient Free & Accepted Masons of Colorado
PETITION OF
FOR MEMBERSHIP BY AFFILIATION
(As an Entered Apprentice or Fellow Craft)
RECOMMENDED BY
Petition Received
And Referred to:
Report Due
Report Received
Ballot Had
Result
Date Date
E.A. Degree ________________ Ex. ______________
F.C. Degree ________________ Ex. ______________
M.M. Degree _______________ Ex. ______________