Date *

MM

DD

YYYY

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday *

MM

DD

YYYY

Oath *

I do most solemnly promise and swear, that I will to the best of my ability comply with all the laws and rules of this Order; that I will recognize the authority of my legally elected officers and obey all orders therefrom not in conflict with my religious or political views, or my rights as an American citizen; that II will not cheat, wrong, or defund this Order, or any member thereof, or permit the same to be done if in my power to prevent it; that I will at all times aid assist a worthy Brother (or Sister) in sickness or distress, so far as it lies in my power to do so; that II will not divulge any of the secrets of the Order to anyone not entitled to receive them. To all of which II most solemnly and sincerely promise and swear. Should I violate this, my solemn oath or obligation, I hereby consent to be expelled from the Order.

Agree

Disagree