Membership Payments

Lodge Name and Number

Name

First

Last

Email

Person Submitting Payments

Worship Master
Secretary
Treasure
Other

Name 1

First

Last

Enter the Brother Name

Masonic Member ID Number

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment Type 1

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Select type of membership.

Name 2

First

Last

Masonic Member ID Number 2

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment Type 2

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 3

First

Last

Masonic Member ID Number 3

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment 3

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 4

First

Last

Masonic Member ID Number 4

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment Type 4

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 5

First

Last

Masonic Member ID Number 5

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment Type 5

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 6

First

Last

Masonic Member ID Number 6

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment Type 6

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 7

First

Last

Masonic Member ID Number 7

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment Type 7

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 8

First

Last

Masonic Member ID Number 8

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment Type 8

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 9

First

Last

Masonic Member ID Number 9

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

Payment 9

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 10

First

Last

Masonic Member ID Number 10

Enter the current Membership ID number for the Brother. If member is reinstating and number is unknown type (Unknown) If new type new member in this box.

15 Membership ID

Payment Type 10

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 11

First

Last

Membership ID 11

Payment Type 11

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 12

First

Last

Membership ID 12

Payment Type 12

Current Memeber – $55.00
New Memeber – $5,800.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 13

First

Last

Membership ID 13

Payment Type 13

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 14

First

Last

Membership ID 14

Payment Type 14

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 15

First

Last

Membership ID 15

Payment Type 15

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 16

First

Last

Membership ID 16

Payment Type 16

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 17

First

Last

Membership ID 17

Payment Type 17

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 18

First

Last

Membership ID 18

Payment Type 18

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 19

First

Last

Membership ID 19

Payment Type 19

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 20

First

Last

Membership ID 20

Payment Type 20

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 21

First

Last

Membership ID 21

Payment Type 21

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 22

First

Last

Membership ID 22

Payment Type 22

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 22

First

Last

Membership ID 22

Payment Type 22

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 23

First

Last

Membership ID 23

Payment Type 23

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 24

First

Last

Membership ID 24

Payment Type 24

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 25

First

Last

Membership ID 25

Payment Type 25

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Name 26

First

Last

Membership ID 26

Payment Type 26

Current Memeber – $55.00
New Memeber – $58.00
Reinstatement – $110.00
Reinstatement (5 or More) – $65.00

Enter Relief Payment Below

Type in Brothers Name and Number then select Payment Type.

Note to the Grand Lodge

Total

$0.00

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