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Masonic Grand Lodge of Oregon
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For Members
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Reporting Forms
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List of Petitions
List of Petitions
At a Stated Communication of the lodge held on:
?
The following Petitions for DEGREES were received and are due for ballot on (4 weeks from date received)
?
Lodge Name & Number
?
Report Month
January
February
March
April
May
June
Jul / Aug
September
October
November
December
Your Full Name
*
?
Your e-mail address
*
?
Title
Secretary
Asst. Secretary
Other
?
Petition Report No. 1
Full Name
DOB
?
Place of birth
Social Security No.
Complete Address
Phone
Occupation
DeMolay
Yes
No
Special Skills
Military Branch
Army
Navy
Air Force
Marines
Other
Highest Rank
Hobbies
Petition Report No. 2
Full Name
DOB
?
Place of birth
Social Security No.
Complete Address
Phone
Occupation
DeMolay
Yes
No
Special Skills
Military Branch
Army
Navy
Air Force
Marines
Other
Highest Rank
Hobbies
Petition Report No. 3
Full Name
DOB
?
Place of birth
Social Security No
Complete Address
Phone
Occupation
DeMolay
Yes
No
Special Skills
Military Branch
Army
Navy
Air Force
Marines
Other
Hobbies
Petition Report No. 4
Full Name
DOB
Place of birth
Social Security No.
Complete Address
Phone
Occupation
DeMolay
Yes
No
Special Skills
Military Branch
Army
Navy
Air Force
Marines
Other
Hobbies
Petition Report No. 5
Full Name:
DOB
?
Place of birth
Social Security No
Complete Address
Phone
Occupation
DeMolay
Yes
No
Special Skills
Military Branch
Army
Navy
Air Force
Marines
Other
Hobbies
Petition Report No. 6
Full Name
DOB
Place of Birth
Social Security No.
Complete Address
Occupation
DeMolay
Yes
No
Special Skills
State
Military Branch
Army
Navy
Air Force
Marines
Other
Highest Rank
Hobbies
I am finished and ready to send this information to the Grand Lodge. Press below to send.
If you have comments or questions about completing this form please call us or
e-mail
the Grand Secretaries Office
Thank you! Form 113
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