Petition for Reinstatement

Eureka Chapter No. 7 Royal Arch Masons

Orlando Council No. 5 Royal and Select Masters

Olivet Commandery No. 4 Knights Templar

Name(Required)

First Middle Last

Date of Birth(Required)

City (Birth)(Required)

State (Birth)(Required)

Cell Phone(Required)

Home Phone

Email(Required)

Current Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date Suspended(Required)

Cause of Suspension(Required)

The petitioner states that he has carefully read the above questions and has answered them truthfully.

Reinstatement Fee(Required)

Price:

The reinstatement fee consists of the current year's dues. Subject to a ballot vote.

Total

Credit Card(Required)

Cardholder Name

Card Details

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