Make your own free website on Tripod.com
Ramapo Lodge #485 Knights of Pythias
KNIGHTS OF PYTHIAS APPLICATION FORM
Home | Messages | Officers List | Recent and Upcoming Events | Scheduled Activities | Bulletin Board | Lodge Photo Album | Related Links | A Knight to Remember | Contact Us | Ads

Application for Membership



Applicant Name: _________________________________

 

              KNIGHTS of PYTHIAS

                                Application for Membership

To  Ramapo Lodge                         Lodge No.  485

Knights of Pythias of   Rockland County

 

 

                                I respectfully apply for membership in your lodge by

 

                                                INITIATION

 

                I declare upon honor that I believe in a Supreme Being, that I am not a professional gambler, or unlawfully engaged in the wholesale or retail sale of intoxicating liquors or narcotics; and that I believe in the maintenance of order and the upholding of constituted authority in the government in which I live. Moreover, I declare upon honor that I am not a Communist or Fascist;  that I do not advocate nor am I a member of any organization that advocates the overthrow of the Government of the Country of which I am a Citizen by force or violence or other unlawful means; and that I do not seek by force or violence to deny to others their rights under the laws of such country.

 

I was born in the City of _____________________________________

State, province or Country of _________________________________

On the ______ day of ______________________________, 19______

I am a citizen of (name of country) _____________________________

Residence (P.O. Address) ______________________________ Phone No. (___)_______ City /State/ Zip Code __________________________________

Occupation __________________________________________

Business address ______________________________________

 

                If this application be granted, I promise a full and faithful observance of all the laws that may govern this lodge and the Order.

 

                The fee of $____45______ accompanies this application.

 

                Written and signed by my own hand this _______________day of _______ 20__

 

                Signed ________________________________________

                                Signature of Applicant

 

                We, the endorsers of the above applicant certify that the applicant posses all of the necessary qualifications for membership in the order Knights of Pythias.

 

                Signed ____________________________  _________________________________

                                Endorsers of Applicant

 

Print out and mail in to:
Louis Schaffer
17 Long Valley Drive
Nanuet, New York 10954
(845)425-5883