Form S-142 - Report Of Committee/petition For Degrees (Page 2 of 2) in pdf

Grand Chapter of Texas, Order of the Eastern Star

Petition for Degrees

_____FOR MAN

_____FOR WOMAN

_____FOR RAINBOW/JOB’S DAUGHTER

(Check appropriate line and fill in 3A, 3B, or 3C below)

Worthy Matron, Officers, and Members of _____________________________Chapter No.____________, Order

of the Eastern Star, State of Texas. The undersigned respectfully petitions to receive the degrees of the Order of the

Eastern Star, and to become a member of your Chapter. If accepted, I pledge myself to a cheerful obedience to the

laws of the Order.

1. I believe in the existence of a Supreme Being.

2. Have you ever been convicted of a Felony or crime involving moral turpitude? (Yes/No)_________

3. Petitioner:

Date of Birth ____________________________________

A. MAN. I am a Master Mason, affiliated with and in good standing in

__________________________Masonic Lodge No.

_______ , A.F. & A.M. in

______________________,_________.

B. WOMAN. I have attained the age of eighteen years and I am the _________________

of_______________________, a Master Mason affiliated with and in good standing in

_______________________ Masonic Lodge No._

_________ , A.F. & A.M. in

_________________, __________.

(If Masonic relative is deceased, add: “at the time of his death”.)

C. RAINBOW/JOB’S DAUGHTER. I have attained the age of eighteen years. I have attached

a certified copy of my Majority Certificate or properly documented proof of three years’ active

membership in the International Order of Rainbow for Girls.

4. I have resided within the State of Texas six (6) months.

5. Have you ever petitioned any Chapter for the Degrees? _

______

_____

_ If so, when and what Chapter?

_________________________________________________________________________________

6. Give name and address of all subversive organizations to which you belong or have ever belonged. (If

none, state none.) Failure to answer this question will be taken as evidence of your membership in such

organization.

Any intentional inaccuracies on the Application Form make the candidate ineligible for membership in the Order of

the Eastern Star.

Recommended by:

_____________________________________

Signed: _____________________________________

Petitioner

_____________________________________

Residence: __________________________________

__________________________________

Telephone __________________________________

FORM S-142

Revised 05/00/2012

Form S-142 - Report Of Committee/petition For Degrees Page 2

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