Active Patrol Petition

ACTIVE PATROL

MEMBERSHIP APPLICATION

I HEREBY APPLY FOR MEMBERSHIP IN THE ACTIVE PATROL. I UNDERSTAND THAT:

1. I am responsible for obtaining my own uniform.

2. I must maintain a 70% active ratio.

3. I am physically able to drill and march in Temple parades.

Name:______________________________________________________________________________

Home Address:_________________________________________ Phone:(______)________________

City:__________________________________________ State:__________ ZIP+4:________________

Occupation/Profession:________________________________ Work Phone:(_____)______________

Birthday Month & Year:__________________ Wife's Birthday Month & Year:___________________

Number of Children: Sons________ Ages________________ Daughters_____ Ages_______

Name, Where & When: Blue Lodge______________________________________________________

Scottish Rite___________________________________________________________________________

York Rite______________________________________________________________________________

Shrine________________________________________________________________________________

Ever been a member of another Unit?____________________________________________________

Recommended by (1)_________________________________ (2)_______________________________

Date Received_________________ Investigating Committee Recommendation_________________

Date Balloted_______________________ Accepted/Rejected_________________________________

90 Days Probationary period ends_______________________________________________________

Upon completion return to any member of the Patrol, or mail to Egypt Shrine Center, PO Box 22805, Tampa, FL 33622, Attn: Secretary Active Patrol along with a check for $50 which will be refunded if you are not accepted.