(406)- 587-3251 or firstname.lastname@example.org
BANNACK HISTORIC LODGE No. 3-7-77
Petition for Life Membership
To: The Worshipful Master, Wardens, and Brethren of Bannack Historic Lodge No. 3‑7‑77.
The undersigned certifies that he is a Master Mason in Good Standing and a member of __________________________ Lodge No. ____, located at __________________, under the jurisdiction of the [Grand Lodge of Montana] [Grand Lodge of ____________________, a Grand Lodge that is recognized by the Grand Lodge of Montana] (Strike out one), and that he is desirous of becoming a Life Member of your Lodge if found qualified. He further certifies that he understands:
That the purposes of Bannack Historic Lodge No. 3‑7‑77 are to preserve the history of Freemasonry in Montana and the original Masonic Lodge building in Bannack, Montana. No degrees will be conferred by this Historic Lodge.
That membership in Bannack Historic Lodge No. 3‑7‑77 shall remain in effect so long as he remains a Master Mason in good standing in a duly chartered Lodge under the jurisdiction of the Grand Lodge of Montana or of a Grand Lodge recognized by the Grand Lodge of Montana. Membership may be voluntarily severed at any time by resignation. Upon resignation, no demit will be issued. (Sec 20070 A and D, Montana Code of Statutes)
That the privileges of holding office and voting in this Historic Lodge are restricted to members who are Master Masons in good standing in a regular Lodge under the jurisdiction of the Grand Lodge of Montana. (Sec 20070 B, Montana Code of Statutes)
Date of Petition: _____________________
Printed Full Name:____________________________________________________________Signature:____________________________________ Address: _______________________________________________ City:__________________________________________________
State,____________________________ Zip:__________ Telephone: _____________________________________________________ e-mail: ________________________________________________
This petition must be accompanied by the petition fee, $37.77. (in U.S. Funds)
A Certificate of Membership, suitable for framing, is available for an additional $5. Check here if you desire the certificate.
A Bannack Lodge No. 3-7-77 lapel pin is available for an additional $5. Check here is you desire the lapel pin.
Shipping and handling for either the certificate or the pin, or for both is $2.23.
Summary of Fees: Petition fee only - $37.77; Petition fee and either pin or certificate plus S&H - $45.00; Petition fee, pin, and certificate plus S&H - $50.00. Checks should be payable to Bannack Historic Lodge No. 3‑7‑77, A.F. & A.M. (in U.S. Funds).
*** All fees and purchase amounts are listed in U.S. Funds and should also be noted as such on any checks from outside of the U.S. ***
A photocopy of the petitioner’s current dues card (front and back) must accompany the petition.
Mail petitions, checks, and all correspondence to the Lodge Secretary:
David Martinez 1311 S. Grand Bozeman, MT 59715
You can also contact the Lodge Secretary by phone: (406) 587-3251 or e-mail: email@example.com