PETITION FOR THE DEGREES OF FREEMASONRY

___________Tallahassee__________________	, Florida this __________ day of __________, _________
                            (City/Town)		                (Month)          (Year)   

To the Master, Wardens, and Members of J. Edwin Larson Lodge No. 361, F. & A.M.:
Having conceived a favorable opinion of the Ancient and Honorable Fraternity of Free and Accepted Masons, and a sincere desire of being serviceable to my fellow creatures, unbiased by friends, and uninfluenced by mercenary motives, I do freely and voluntarily offer myself as a candidate for initiation into the mysteries of your time-honored institution, and if elected, will cheerfully conform to all the ancient and established usages and customs of the Fraternity, which I understand are based on the highest principles and moral precepts and incorporate no unseemly conduct.

(The Petitioner will answer each of the following questions fully – Print or type, except signature)

Do you believe in the existence of one ever living and true God? _______________

PERSONAL INFORMATION

Full Legal Name: ____________________________________________________________________________________
Current Address:  ____________________________________________________________________________________
Email Address:  _________________________________________________   Mobile Number: _____________________ 		
Other names/alias you have used ________________________________________________________________________
Where were you born? ________________________________  Date of Birth ____________________    Age __________
				(City/State/Country)			(MM/DD/YYYY)
How long have you resided there? ________________    How long have you resided in Florida? _____________________
			                  (Years/Months)					      (Years/Months)
Where have you resided in the last 5 years? ________________________________________________________________
				             ________________________________________________________________
What is your present Occupation?  _______________________________________________________________________
Employer’s Name, Address, and Zip Code: ________________________________________________________________
Employer’s Telephone Number: ___________________________   How long employed: ___________________________
Other employers for the last five years:  ___________________________________________________________________
			                     ___________________________________________________________________
Spouses Name:   _____________________________________________________________________________________   
Children’s Names/Age:  _______________________________________________________________________________
Do you know of any physical, mental, legal or moral reason which would prevent you from becoming a Freemason? Y     N
If yes, please explain:   ________________________________________________________________________________
___________________________________________________________________________________________________
Do you believe, or have you ever believed in the overthrow of the government of the United States of America by force or infiltration, or been a member of an organization who advocates the same? Y     N      (if yes, give names and dates) ________________
Have you ever been a member of the Order of DeMolay?  ____________________ What Chapter? ____________________
Offices held: _________________________________________________________________________________________
Would you be interested in serving with one or more of our youth organizations?  Y       N
BACKGROUND INFORMATION
Have you previously applied for, or been proposed, as a candidate for the Degrees in a Masonic Lodge?  Y      N
If yes, when and what Lodge?  __________________________________________________________________________
What were the results?  (explain) ________________________________________________________________________
Have you ever been arrested, plead guilty, no contest, or received a non-adjudication of any crime?  Y      N
If yes, please explain: (list when and where) _______________________________________________________________

CRIMINAL BACKGROUND INVESTIGATION

By submitting this petition, the Petitioner acknowledges and agrees to the following:

•	The Petitioner voluntarily consents to undergo a criminal background check.
•	The Petitioner agrees to submit and pay for the required background screening through the approved provider as part of the petitioning process.
•	The results of the background check will be provided to the Investigation Committee for review and used solely for the purpose of recommending this petition.

DIGEST OF MASONIC LAW OF FLORIDA
Chapter 31 
31.03 A Lodge may not receive a petition for the Degrees of Freemasonry from any person who has been convicted of a felony and who has not been restored to full civil rights.

Criminal Background checks must be ordered by going to this URL in any web browser:

http://www.infocheckusa.com/masons-ordering-florida.html

A copy of the report must be sent directly to the Secretary by using the Secretaries email address provided in the “Additional Email Address” field.

Lodge Secretaries Email Address: LarsonLodge361@gmail.com 

ELECTRONIC COMMUNICATION CONSENT

I hereby consent to receiving electronic communications from the Grand Lodge and/or the Lodge to which I am a member of.

    _______________
Initials

I hereby certify on my honor that all these answers are true and correct, and that I have read, understood, and agree with all the statements made on this application form, and hereby agree that I will not petition any other body of Masonry for Degrees for a period of six months after receiving my Master Mason Degree, or until I have passed a satisfactory examination in the catechism of the Master Mason Degree.

(44.07 Obtaining a Degree or Degrees of Freemasonry by fraud, untrue statements or representations or by knowing concealing and withholding information relevant and material to eligibility for such Degrees is proper subject for Masonic Discipline)

SIGN YOUR FULL NAME (in ink) _________________________________________________________________________________________________

(Type or print your full name) _______________________________________________________________________________________________________

Initiation Fee (First Degree) ................................................................................. $ 65 
Fellow Craft (Second Degree) .............................................................................. $ 30
Master Mason (Third Degree) .............................................................................. $ 30
George Washington National Monument Association ......................................... $ 5.00 E.A.
TOTAL OWED WITH PETITON………………………………$130

Annual Dues ......................................................................................................... $ 141
Masonic Home Endowment Fund (Voluntary) .................................................... $ 18.25
Total Annual Dues with Masonic Home Contribution ........................................ $ 159.25

RECOMMENDATIONS
We recommend the above petitioner as a candidate for the Degrees of Masonry, based upon our belief that he is of good moral character, temperate, industrious.
(Must have two recommendations)

Signatures of Members of the Lodge to which the petition is directed: {

REFERENCES
(NOTE: SHOULD BE DIFFERENT FROM ABOVE RECOMMENDATIONS)

Each petitioner is required to furnish in the space provided below, the name of three (3) persons (preferably Masons, local) as references that have known
him for a period of five years or more.

(1.) ____________________________________ _________________________________________________________ ___________________________________
(Name)					(Address)					(Telephone) 

(2.) ____________________________________ _________________________________________________________ ___________________________________
(Name)					(Address)					(Telephone) 

(3.) ____________________________________ _________________________________________________________ ___________________________________
(Name)					(Address)					(Telephone) 

FACTS CONCERNING FREEMASONRY
PETITIONER MUST READ THE FOLLOWING

Having expressed a desire to become a Freemason, we presume you are willing to consider thoroughly the step you propose to take.  The exact nature of our institution being unknown to you, we deem it advisable that you should be informed on certain points, the knowledge of which may affect your decision to apply for membership.
Freemasonry interferes neither with religion nor politics, but has for its foundation the great basic principles of the Fatherhood of God and the Brotherhood of Man.  No atheist can be a Freemason. Freemasonry strives to teach a man the duty he owes to God, his neighbor, and himself.  It includes the practice of virtue and makes an extensive use of Symbolism in its teachings.
It cannot be too strongly emphasized that Freemasonry is not entered in the hope of personal gain or advancement. Admission thereto must not be sought from mercenary or other unworthy motives. The aim of the true Freemason is to cultivate a brotherly feeling among men, and to help whomsoever he can.
Freemasonry is not a Benefit Society.  This fact cannot be too strongly emphasized.  We do not subscribe so much a year to entitle us to draw sick pay or other benefits, or to make provisions for those who survive us.  However, each Mason is expected to provide for the future of his family.  No man should enter the ranks of Freemasonry in hope or expectation that he will derive any financial benefit from it; Masonic Charity is directed towards those who, from unforeseen circumstances and through no fault of their own, have met with misfortune.  To be eligible for resident, non-resident, or other relief programs a Florida mason must have been a member in good standing of a Florida Lodge for not less than 10 years, the last 3 years whereof must have been continuous at the time application is made and he would not be eligible for such relief if he had already attained the age of 70 years at the time he became a Florida Mason.
Loyalty to one’s country is an essential qualification in Freemasonry, and only those acceptable who cheerfully render obedience to every lawful authority. Disloyalty in any form is abhorrent to a Freemason, and is regarded as a serious Masonic offense.
Freemasonry has in all ages insisted that men should come to its doors entirely of their own free will, and not as a result of solicitations, or from feelings of curiosity, but simply from a favorable opinion of the institution, and a desire to be ranked among its members.
We have no authority at present to give you further information regarding the Fraternity you propose to join, but we have imparted sufficient information to enable you to conclude that Freemasonry is not contrary to the principles, which mark a man of upright heart and mind, and has in it nothing inconsistent with one’s civil, moral, or religious duties.
We think it advisable to inform you that your admission to our Craft will entail certain financial obligations which you should be able to discharge without detriment to yourself or those dependent on you.  In addition to the fees payable on your entrance, there will be annual dues for the support of your Lodge.
Before presenting this petition, be sure in your heart that you are not prompted by mere curiosity, the desire for commercial gain or social prestige.  For such motives, Freemasonry has no reward.

Initials: ____________