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Petition Online Form

AAD Shrine’s Petition For Initiation and Membership

TO THE POTENTATE, OFFICERS AND NOBLES OF AAD SHRINERS, SITUATED IN THE OASIS OF HERMANTOWN, DESERT OF MINNESOTA : I, the undersign, hereby declare that I am in good standing in * Required

Lodge Name and Number *

Lodge Location *

Furthermore, I do not now, and never will, hold membership in or allegiance to, any Body claiming to be Masonic that hasbeen declared clandestine by a Commandery or Preceptory of Knights Templar in amity with, and recognized by the GrandEncampment of Knights Templar of the United States of America, or Consistory of the Ancient and Accepted Scottish Rite ofFree Masonry of the obedience of wither the Supreme Council of the Northern or of the Southern Masonic Jurisdiction of suchRite in the United States, or of a Supreme Council in amity with and recognized by them; that I have resided within thejurisdiction of your temple, or in unoccupied territory, not less than 6 months, as required by the By Laws of The ImperialCouncil, and that I am not under suspension or expulsion in the body prerequisite to this Order, and respectfully request that Imay be made a Noble of the Mystic Shrine, and become a member of your organization.If I be found worthy, and my request granted, I promise to conform to the Articles of Incorporation and By Laws of Imperial Council and the By Laws and Ceremonies of your organization.

Birthplace (City, State) *

Date of Birth *

Were you ever a Demolay ? *

If so, what was the Chapter name and location ?

Profession or Occupation *

Have you previously applied for admission to any Shrine Center ? *

If so, Which ? *

When ? *

Resident Address *

City, State, Zipcode *

Phone Number *

Hat Size *

Email *

Today's Date *

Print Signature *

Print Full Name Here *

Wife's Name *

Recommended and Vouched for on the Honor of

Noble #1 Full Name and Member Number *

Noble #2 Full Name and Member Number *

Payment of $150.00 must accompany petition

Other Inquiries

Call 218.722.7488 for more information or to be contacted by one of our membership committee members.