ST. ANDREW’S LODGE, No.56, F.& A.M.

351 Middle Street

Portsmouth, New Hampshire

St. Andrew’s Lodge No. 56 F & A.M.

Craig I. Brown, Secretary Telephone: (603) 436-9208

351 Middle Street

Portsmouth, NH 03801

Petition to Receive the Degrees of Freemasonry

To the Worshipful Master, Wardens, and Brethren of St. Andrew’s Lodge, No. 56 Free and Accepted Masons, Portsmouth, New Hampshire:

Having long entertained a favorable opinion of your ancient institution, I respectfully make application for membership in St. Andrew’s Lodge, No. 56, Portsmouth, NH. If accepted, I promise a cheerful obedience to the By-laws of your Lodge, to the requirements of the M.W. Grand Lodge of New Hampshire, and to the ancient landmarks, usages, and customs of the Craft.

Full Name (include Middle Name): ..………………………………………………………

My place of residence (full address): ………………………………………………………

………………………………………………………………………………………………

Place of Birth: …………………….……… Date of Birth: ………………………

Occupation: …………………………………………Telephone: ………….……………...

I certify that I have/ have not (circle one) previously applied for initiation to any Masonic Lodge. If you have, please give name and location of said lodge and date of application.

………………………………………………………………………………………………

I understand that the petition fee of $75 must be submitted with this petition, and that first-year dues will be prorated based on the current $70 annual dues.

Signature: ……………………………………………….. Date: …………………….…….

We, members of St. Andrew’s Lodge, No. 56, are personally acquainted with the above applicant, and from a confidence in his integrity and uprightness of his intention, recommend him as a proper candidate for the mysteries of Masonry.

Signed: 1)………………….……..……

2)…………..………………….

3)………….………………….. Committee:

Deposit Received: date………………………….…………...Sec’y 1)………...…………………

Balloted for and passed/rejected: date……………………….Sec’y 2)…………………………...