Masonic Grand Lodge of Oregon :: Past Master Certificate Application

Past Master Certificate Application

Please be sure to fill out the form before submitting

Date of request:
Lodge:
Lodge No.
City:
Please send me a Past Master Certificate for:
Brother:
For the Masonic Year of:
Certificate and Pocket Card is $5.00 Also send the Following: (Please check either the Yes or No box on each line) Frame for the Certificate is an additional $10.00. :Yes or No Oregon Past Master Emblem is an additional $5.00. :Yes or No
Secretary
Please enter your e-mail address here:
The lodge will be automatically billed on the annual billing.
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!