former member acknowledgment o

1 Date of Application Women of the Moose applicants, Moose Legion (ML) applicants, former member applicants as well as reinstatement and transfer requests must contain your current or prior Moose ID No. which may be obtained from the lodge, chapter, ML or Moose International Membership ID Expiration Date (if applicable) Please PrintName Address City State/Province Zip Country Date of BirthCell phone numberEmail Occupation Marital Status (Check one) o Single o Married (Spouse s Name)

2 Your Invitation toWe provide hope to children in need at Mooseheart, a 1,000-acre community and school for children and teens in need. Mooseheart has provided over 12,000 children a second chance, with quality education and vocational training on a campus environment that stresses stability, compassion and offer a special world of comfort and peace of mind to senior members and their spouses at Moosehaven, a retirement community located in Orange Park, Florida. Residents enjoy activities, camaraderie, and a contentment that most agree, could not be found place special emphasis on giving back to our communities through a wide range of service programs.

3 Whatever the need, we are there, giving our time and effort to make our communities better places in which to have fun too! Our members participate in a wide variety of activities, from sports to picnics, to dances and karaoke. There s a good chance you will meet lifelong friends once you join and become complete this application for membership or join online at to remit the appropriate application fee and annual membership dues. It will be the best decision you ve ever made!Application Type: o New o Re-Enroll o Reinstatement* o Transfer* o Multiple* *Current Lodges, Chapters and Moose Legion s p o n s o r i n f o r m at i o n I propose (applicant name) for membership in Lodge/Chapter/Moose Legion No.

4 City State/ProvinceSponsor s name Sponsor s ID #ID# must be submitted in order to receive sponsor name Lodge/Chapter/ML State/ProvinceZip CountrySponsor s phone Sponsor s emailSponsor s signature Required fee and membership dues for new and former members must accompany this official application. Dues payments, and fees, are not deductible as charitable contributions for federal income tax received with application $Dues received with application $Endorser s signatureEndorser must be a member of the Lodge/Chapter/ML the applicant is o r m e r m e m b e r a c k n o w l e d g m e n t I understand and acknowledge that, by re-enrolling into The Moose, I will lose all prior years of membership in the Fraternity, which may affect my qualifications for Moosehaven admission.

5 I further understand that I can apply for reinstatement into the fraternity within two years after the expiration date of my membership card. I may only reinstate into the lodge, chapter or Moose Legion from which I was dropped for non-payment of dues or General Assembly/Allheart. By reinstating, I will retain my prior years of service in the Fraternity. (Must be signed by applicant if applying for membership as a former member .)Signature of former member Check the appropriate box: o Male o Female Applying for: o Moose Membership o Women of the Moose Membership* o Moose Legion (ML) Membership* (**Must be a current Moose member to apply.)

6 Join!Visit to join online It s Simple!Membership Application Join nearly one million men and women who have accepted an invitation to make a difference in many lives through membership in The h e m o o s e f r at e r n i t ya p p l i c a n t i n f o r m at i o nSign the Obligation Of Membership on reverseSubmit this form and payment to the lodge/chapter, MooseLegion to which the individual is Lodge/Chapter/ Moose oneMoose International must be notified by the lodge, chapter or Moose Legion once your application for membership receives a favorable vote. At that time, Moose International will issue your official membership : Moose Legion new applicants must attend a conferral ceremony to complete the process.

7 This receipt may be required for more information visit contents copyright and TM 2021 Moose International. All rights reserved. Printed in Moose International, 155 S. International Dr. Mooseheart, IL 60539 (Rev. 3/2021)m o o s e l e g i o n d e g r e e o f s e r v i c eAre you ready to take the next step in Fraternalism?Are you ready to take the next step in Fraternalism?Why a male Moose lodge member should consider advancing to the Moose Legion:m The opportunity to make even more of a difference in the lives of those at Mooseheart and Moosehaven. The majority of dues and fundraising efforts go into programs for our kids and seniors.

8 M Increased level of pride in one s membership. Moose Legion members have a feeling of accomplishment knowing their membership matters even more. The Moose Legion is a Higher Degree of The Activities planned by local lodge Moose Legion committees or jurisdictions for members and families add a new level of enjoyment to your o m e n o f t h e m o o s eWhy a female Moose lodge member should consider joining the Women of the Moose:The Women of the Moose provides social, sports, family The Women of the Moose provides social, sports, family and community service opportunities in a fraternal setting. and community service opportunities in a fraternal setting.

9 members of the Women of the Moose dedicate many volunteer members of the Women of the Moose dedicate many volunteer hours to those in need, not only in their own chapters but, hours to those in need, not only in their own chapters but, more importantly, to those in their importantly, to those in their main objectives of the Women of the Moose are:m Assist in the support and maintenance of the 1,000-acre community and school in Illinois called Mooseheart, for children and teens worldwide who, for whatever reason, lack a stable Assist in the support and maintenance of a 65-acre retirement community near Jacksonville, Florida called Moosehaven, where senior members and their spouses enjoy their golden years together in dignity, comfort and am 21 years of age or older, profess a belief in a Supreme Being, and am not a member of a terrorist group or recognized subversive organization.

10 I have never been a registered sex offender or convicted felon. I am of good moral character and have not been expelled, suspended or rejected for original membership by any lodge, chapter or Moose Legion of The Moose. I understand that the use of the social quarters of any lodge of The Moose shall be in conformity with the rules and regulations of the lodge. Finally, I certify that the information I have provided is true and that no omission or concealment of information has been made of any fact or circumstance. I understand and agree that my membership in The Moose is conditioned upon the approval of the Application Review Committee and a favorable vote of the elected into membership, I promise to fulfill my two primary obligations of 1) increasing the strength of The Moose by proposing for membership qualified individuals of high personal character and 2) giving of my energy and substance in support of Mooseheart and Moosehaven.