FEES: E.A. $_______ F.C. $_______ M.M. $_______ Pet. No.
:_________
Date:____________
Petition for Degrees
To the Worshipful Master, Wardens and Brethren of
Free and Accepted Masons of Ohio
The Petition of the Subscriber Respectfully Showeth:
That he has long entertained a favorable opinion of your Ancient Institution and is desirous of
being admitted a member thereof, if found worthy;
That he believes in the existence and perfection of God.
Have you ever petitioned a Lodge of Free and Accepted Masons anywhere?
Yes _____ No _____ If you have, state what Lodge, where situated and when petitioned.
_____________________________________________________________________________
His present residence is____________________________________________________________
No. Street City Zip Phone
where he has lived since the ________ day of________ , ________ Soc. Sec. No. _________________
He was born at ____________________ on the __________ day of__________ , A.D. ___________
His occupation is _________________________ Place of business___________________________
Dated at _____________________________ this __________ day of _____________ , A.D. _______________
Recommended By
Bro. _______________________________________ Signed ______________________________________
(SIGN FULL NAME. Abbreviations or initials not sufficient)
If no Middle Name write word "NONE"
Bro. _______________________________________ _______________________________________
TYPE OR PRINT NAME IN FULL ON THIS LINE
Questions to be PETITION FOR DEGREES Initiated __________________
Answered by Petitioner
By _______________________
On night of Initiation
1. Do you declare upon your honor that Lecture by ________________
you have never made application to any Name ____________________
Lodge of Free and Accepted Masons? Exam ____________________
Address __________________
Answer ___________________________ By _______________________
City______________________
2. Do you have a steadfast belief in the
existence and perfection of God?
ZIP ______________________
∗ ∗ ∗ ∗ ∗ ∗ ∗ ∗ ∗
Answer ___________________________
Phone ____________________ Passed ____________________
3. Do you declare upon your honor, that,
unbiased by friends and uninfluenced by Fee Enclosed $ _____________ By _______________________
mercenary motives, you freely and
voluntarily offer yourself a candidate for Fee F.C. __________________ Lecture by ________________
the misteries of Freemasonry?
Fee M.M. _________________ Exam ____________________
Answer ___________________________
COMMITTEE By _______________________
4. Do you declare upon your honor, that
∗ ∗ ∗ ∗ ∗ ∗ ∗ ∗ ∗
you are prompted to solicit the privileges
Received ,___________ AD _____
of Freemasonry by a favorable opinion
conceived of the institution, a desire for Cmte Notified __________ AD_____
knowledge, and a sincere wish of being Raised ____________________
serviceable to your fellow-creatures? Elected , ____________ AD _____
Answer ___________________________ By _______________________
Rejected ______________ AD _____
5. Do you declare upon your honor, that REPORT OF Lecture by ________________
you will cheerfully conform to all the
ancient usages and established customs of INVESTIGATING Exam ____________________
the Fraternity? COMMITTEE
Answer ___________________________ * _____ Favorable _______________ By _______________________
* _____ Favorable _______________
Signed ____________________________
* _____ Favorable _______________
Attest: ____________________________
* If the report is Unfavorable write
____________________________ "Un" before the word Favorable.
STEWARDS
