Reinstatement Form

INSTRUCTIONS FOR

REINSTATEMENT APPLICATION FORM

1.  Who Qualifies?  Any unaffiliated Member who was stricken from the roles through nonpayment of dues or through an Absolute Dimit or Certificate of Release from another lodge due to nonpayment of dues

2.  Do not write in the first 3 lines of the form unless you know the name of your proposer

3.  Start the application on line 4 with your name

4.  Submit the completed application with a $25 application fee to the office