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Grand Lodge of Iowa, A. F. & A.M.

Code of 2000 Chap. 23, Sec 2

Iowa Official Form No. 8

PETITION FOR THE DEGREES OF MASONRY

(Please print)

To the officers and members of _______________________________ Lodge No. _______ Ancient, Free and

Accepted Masons at ________________________________, Iowa, I, respectfully petition your lodge for the

Masonic Degrees of Entered Apprentice, Fellow Craft, and Master Mason.

Full name: First: ____________________ Middle: ___________ Last: ________________________________

Date of Birth: _________________________ Place of Birth: ________________________________________

Mailing address: ___________________________________________________________________________

City: __________________________________ State: __________________________ Zip: _______________

Home Phone: ___________ Cell Phone: ___________ E-mail: _______________________________________

Do you profess a faith in a Supreme Being? Yes___ No ___ I have resided in Iowa continuously since ________

I resided previously in City _____________________________ State _________________________________

Wife’s name: ______________________________Names and ages of minor children: ___________________

________________________________________________________________________________________

Have you ever been convicted of a felony or a misdemeanor other than a minor traffic offense? Yes_____ No_____

If yes explain the offense and when____________________________________________________________

_________________________________________________________________________________________

I am willing to submit to a criminal background check. Yes___ No ___

Have you ever previously petitioned a Masonic lodge? Yes___ No ___ If yes, I applied for membership

in___________________ Lodge No. _____ located at _____________on ___________ and was rejected.

My occupation is: ________________________ Employer: _________________________________________

Address: _________________________________________________________________________________

References - Names and Addresses:

(They need not be members of the Masonic Fraternity)

1. _______________________________________________________________________________________

2. _______________________________________________________________________________________

3. _______________________________________________________________________________________

All of the statements I have made in this petition are true and correct to the best of my knowledge. An intentional

misstatement of the facts on this petition is a Masonic offense. The penalty shall be expulsion. I understand that

by submitting this petition I may be subject to a criminal background inquiry. An additional release form will be

required.

Signature: ________________________________________ Date: _______ Fee Enclosed $ __________

We the undersigned members of this lodge recommend the applicant as a proper candidate for the mysteries of

Masonry.

Name/Address: ____________________________________________________________________________

(Committee use only)

The Worshipful Master appointed the following brothers as the Investigating Committee to meet with the petitioner.

Committee

Report

1. ____________________________________________________

__________

2. ____________________________________________________

__________

3. ____________________________________________________

__________

9-15-2015

Iowa Official Form 8 - Petition For The Degrees Of Masonry - Grand Lodge Of Iowa, A. F. & A.m. Page 2

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