Ancient and Accepted Scottish Rite of Freemasonry

Southern Jurisdiction of the United States

Valley of Jacksonville, Orient of Florida

965 Hubbard Street,

Jacksonville, Florida 32066

Phone: (904) 355-7633

Fax: (904) 355-7443

This petition may now be printed from the following pdf file.

Petition For Degrees pdf.file

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PLEASE PROVIDE THE FOLLOWING INFORMATION

Check One:   Spring Reunion       Fall Reunion

              Date: 

Enter your full name (no initials please)

First Name:     

Middle Name: 

Last Name:     

Address:         

City:                 

State: Zip:

Home Phone:  

Work Phone:   

Cell Phone:     

E-mail:             

Occupation:    

Date of Birth:  

Place of Birth: 

I certify that I am a Master Mason in Good Standing in:

Lodge:   Number:

Under the Grand Lodge of:      

Date Raised to Master Mason:

Date of Proficiency ( If Master Mason less than 6 months )

If you have previously applied for these Degrees, state fully, date, place and to whom application was made:

Are you a Past Master?  Yes  No

If so, where?  When?

Are you a Past District Deputy Grand Master?  Yes  No

If so, which District?

If you are married, wife's name: Anniversary:

If different from above

Mailing Address:

                     City:

                  State:

                     Zip:

1. The Supreme Council requires the acceptance of the following fundamental principles: The inculcation of patriotism, respect for law and order, undying loyalty to the principles of civil and religious liberty and the entire separation of church and state as set forth in the Constitution of the United States of America. Do you wholeheartedly approve of these principles?

Yes         No 

2. Have you ever held or expressed opinions contrary to the foregoing or have been affiliated with any organization which has? If your answer to this question is Yes, give particulars.

Yes         No 

Wholeheartedly believing in the foregoing, I respectively petition the Jacksonville Scottish Rite Bodies to receive the 4th. thru 32nd. Degrees; and by submitting this form agree to all of the above principles.

                         (insert the name of a Brother that you desire to be your Top Line Signer)

Recommended by:

                             (Member of Jacksonville Scottish Rite Bodies)

Recommended by:

                             (Member of Jacksonville Scottish Rite Bodies)

Jacksonville Scottish Rite Initiation fee is $230.00; this includes $175.00 initiation fee plus yearly dues of $55.00, for all Degrees. A $100.00 deposit is required up front.

  I will send you a check.

             I will send you a money order.

Make check or money order payable to:

Jacksonville Scottish Rite Bodies

Send to the above at:

965 Hubbard Street

Jacksonville, Florida 32206

Phone: (904) 355-7633

Fax: (904) 355-7443

Ill. Jack M. Newport, 33°, Webmaster@aasrvalleyofjax.org

Ill. David A. Yarborough, 33°, General Secretary

Jacksonville Scottish Rite Masonic Center

965 Hubbard Street

Jacksonville, Florida 32206

Phone: (904)355-7633

Fax: (904)355-7443

Scottish Rite Office Hours-Monday-Friday-8:00 AM-4:00 PM

This Website was last updated on  March 19, 2008