Craft Request Initiation Ceremony

GRAND LODGE OF SOUTH AUSTRALIA & NORTHERN TERRITORY

This form is to advise the administration of a request to conduct an Initiation Ceremony

Select The Lodge Below(Required)
Click below to drop down the list.
Name of person to be Initiated(Required)
Email address of person to be initiated(Required)
Phone number of person to be initiated
Full residential address details including suburb and postcode(Required)
Full postal address details including suburb and postcode (if different to residential)
Are you planning on conducting the Initiation Ceremony within(Required)
Has this person been balloted?(Required)
- Yes
- No
Date Balloted(Required)
DD slash MM slash YYYY
When will the ballot be conducted by?(Required)
DD slash MM slash YYYY
Reason the individual has yet to be balloted?(Required)
Has a summons been issued?(Required)
- Yes
- No
Date of Initiation Ceremony(Required)
DD slash MM slash YYYY
Name of Person Requesting this Ceremony(Required)
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Email of Person Requesting this Ceremony
Email of Person Requesting this Ceremony(Required)
Phone Number of Person Requesting this Ceremony
Signature of Person Requesting this Ceremony
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