Fee of $100.00 required with this Petition
Petition for Degrees
To the Worshipful Master, Wardens, and Brethren of:
LA Harbor Lodge No. 332, F. and A. M.
San Pedro, California
Phone: _____________________________
Street: __________________________
I
______________________________________________ a resident of
__________________________
First Middle Last
in the State of California, hereby voluntarily offer myself as a candidate for the mysteries of Freemasonry. I declare upon my honor that I am not influenced by mercenary or unworthy motives, being prompted by a favorable opinion of the institution, and a sincere wish to be serviceable to my fellow-creatures.
I promise, if accepted, a cheerful obedience to the By-Laws of your Lodge, to the requirements of the M. W. Grand Lodge, and to the ancient usages of the Craft.
I was born in the town of __________________________ in the State of ___________________
on the _________________ day of _____________________, A. D. 20___
I am by occupation a ______________________________________________________
I have certain interests in our Lodge (Optional) _____________________________________
I have the following interests ______________________________________________________
My email address to be used for only Lodge information: ___________________________
I have not / have applied to any Lodge for the degrees of Masonry, in this or any other jurisdiction. (Circle one)
If applied, Lodge name and place: _____________________________________________________