Masonic Yacht Club, Inc.
Application for Membership |
Your Date of Birth:: _____/_____/_________ Spouse’s Name:: ______________________________
Home Address:: ____________________________________________________________________
City: ___________________________________ State: ________ Zip + 4: ________________
Home Phone w/area
code (_____)_______________ Home Fax w/area code
(____)________________
Cell Phone w/area
code (_____)_______________ E-Mail: ___________________@______________
Pager w/area
code (_____)_______________ Car/Boat Phone w/area
code
(_____)_______________
Business Name: ____________________________________________________________________
Business Address: __________________________________________________________________
City: ___________________________________ State: ________ Zip + 4: ________________
Work Phone w/area
code (_____)_______________ Work Fax w/area code (_____)________________
Masonic Lodge Name
& Number: _______________________________________________________
Lodge Address/District: _______________________________________ Meets on: ______________
Your Masonic Title (Bro., Wor., VW, RW, MW): ___________ DSA?: ________ Date Raised: ___________
Your Grand Lodge ID Number (found on your Dues Card): ______________________________________
Do you own a boat?: ________ Where is it moored?: _______________________________________
Please describe it: ___________________________________________________________________
__________________________________________________________________________________
Initiation
Fee = $100.00.
Please enclose a copy of your current
MASONIC LODGE DUES
CARD & a check in the
amount of $100.00, made payable to Masonic
Yacht Club; Mail to:
|
Robert Stein, Secretary |
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