PETITION FOR MEMBERSHIP
BALLUT ABYAD SHRINERS
LEGION OF HONOR
ALBUQUERQUE, NEW MEXICO
TO THE
OFFICERS AND MEMBERS OF THE LEGION OF HONOR, BALLUT ABYAD SHRINERS OF NEW MEXICO:
I,_____________________________,
a member in good standing of Ballut Abyad Shriners of New Mexico, hereby apply
for membership in the Legion of Honor. I
attach a fee of $5.00 for dues until December 31, 2003. I commit myself to purchase or obtain The
Legion of Honor Uniforms and accessories through the Quartermaster. I understand the annual dues are $5.00, as
stated in Article 1, Section 5 of the Bylaws of the Legion of Honor. The
following information is submitted:
Residence:_________________________________________________________________________________
Number Street
City
Zip
Telephone: Business:(505)_________________Home:_(505)
__________________
Fax: (505)
____________________
E-mail: _____________________________
Military
Status: Reserve___ Active Duty___
Ret.___ Hon Sep __ N/A
_____
Branch of
Service:_______________.
Non Military
relationship____________________
Date of
Birth__________________, Place__________________________________
Marital
Status: Single___, Married____, Widowed ___, Wife's Name__________________
Recommended by
Legion Noble:________________________________
Signed____________________________________,
Date______________
Date of
Election______________, Rejection________________
Change of
Status_______________, Reason_______________
Form Revised:
1/23/2003