Miami York Rite of Freemasonry

To the officers and members of Jericho Chapter No. 11, Royal Arch Masons of Miami, FL.: (Fee: $65)

The subscriber respectfully represents that he is a Master Mason in

Lodge Name

Lodge No.

City

State

Raised Date

and now prays to receive the Degrees in JERICHO CHAPTERNo. 11, R.A.M. of Florida, and if elected promises a cheerful compliance to all the laws, rules and regulations thereof.

Date of Birth

Month

Day

Year

Place of Birth

Occupation

Address

Phone

and has never been Elected or Rejected for the degrees conferred in any Chapter of R.A.M. and that he is a citizen of the U.S.A.

First name

Last name

Signature

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Recommended by Members of the Chapter to which petition is submitted

Companion

Miami York Rite of Freemasonry

SECRETARY/RECORDER

PHONE

EMAIL