Jerusalem Grand Chapter - jgc-oesphafl.org

1 Jerusalem Grand Chapter Order of the Eastern Star State of Florida & Jurisdiction, Prince Hall Affiliated Working under the protection of The Most Worshipful Union Grand Lodge of Florida & Belize, Central America and St. John, Virgin Islands, Inc. Sister Lillian L. Carter Rev. Ronald E. Williams, Sr. Grand Worthy Matron Grand Worthy Patron The Honorable Walter Gulley, Jr. The 18th Most Worshipful Grand Master FORM OF PETITION. FOR MEMBERSHIP FOR A LADY. 20. THIS SECTION MUST BE COMPLETED BY THE SUBORDINATE CHAPTERS (check the appropriate box). Date of Membership: _____. New Petitioner NB Dispensation Reinstatement Transfer/Demit Travel Card To the Worthy Matron, Officers and Members of Chapter No.

2 Of the Order of the Eastern Star (OES). Your petitioner, the daughter, widow, wife, sister or mother of Bro. _____. _____ of _____ ____ Lodge No. _____. located at _____State of _____, solicits the light and privileges of the Order of Eastern Star in your Chapter . If the prayer of her petition is granted, she pledges her honor that she will, in all respects, conform to the legal requirements of your Chapter , and be subject to the constitutional rules and regulations of the Jerusalem Grand Chapter . Do you believe in a Supreme Being? Yes No Full Name: D/O/B. Address: City Zip Phone: _____ Email: Is this application of your own free will? _____ Occupation _____.

3 Have you ever been a member of, presented a petition to or been rejected by ANY OES. Chapter ?_____ And if so, when and what Chapter ? _____. Signature: Proposed by: Address: City Zip The Petition Fee in the amount of $_____ will be explained to me by the Investigation Committee. 1 of 2 2017. References: Name/Phone: Name/Phone: Name/Phone: _____. Referred to the following Investigation Committee: Title: Title: Title: Title: Report of Investigation Committee on Character 20. At the conclusion of the investigation performed _____/_____ 20_____ on said petitioner, this committee (as noted above), find her: Favorable Unfavorable for consideration of membership to Chapter No.

4 For the following reason(s): _____. _____. _____. Election (vote) of the Chapter : Favored_____ Opposed_____ __ Abstention_____. FOR Grand Chapter OFFICE USE ONLY. Date Received: _____. Approved Pending Request Denied ESBA Received: _____Travel Card Request: _____Amount Enclosed: Certificate Mailed: _____. Attest: ( Grand Secretary Signature). Mail to the Office of the Grand Secretary Sister TinaMarie N. Campbell Box 61766 Palm Bay, FL 32906. 321-745-5090. 2 of 2 2017.