Petition for
The Orders
To the Commander, Generalissimo, Captain General and Sir Knights of
PIEDMONT COMMANDERY No. 26, Knights Templar of Virginia:
Full Name: _____________________________________
Date of Petition: _____________________
The undersigned, who has resided in the Commonwealth of Virginia for the year immediately prior to the date of this petition
and for the six months last past within the jurisdiction of the Commandery to which this petition is addressed, and who is a firm
believer in the Christian religion, is desirous of receiving the Orders of Knighthood in your Commandery. If found worthy of
membership I promise to conform to the ancient usages and customs of the Order and Bylaws and Constitutions of the same.
I have read this petition and declare the within statements to be correct to the best of my knowledge and belief.
1. I am now a member of ____________________________________________________ Lodge No. ___________, holden under
the Grand Lodge of _________________________________________________________
2. I am a member of ____________________________ Chapter No ______________ holden under the jurisdiction of the Grand
Royal Arch Chapter of __________________________________________ (or I have petitioned _______________________Chapter
No. ______, holden under Grand Chapter of _________________________, Royal Arch Masons, for the Capitular degrees and will
be affiliated with _________________________ Chapter No. ______________, holden under the jurisdiction of the Grand Royal
Arch Chapter of ______________________________________________
3. Have you ever petitioned this or any Commandery of Knights Templar (Y/N) _______? If so, state the name, number and location
of each such Commandery and the result of every petition: ___________________________________________________________
__________________________________________________________________________________________________________
(PLEASE PRINT CLEARLY)
4. FULL NAME: (First) _______________________ (Middle) ____________________ (Last) ____________________________
5. HOME ADDRESS: _______________________________________________________________________________________
(City) _________________________________________ (State) _______________ (Zip Code+4) _________________________
6. PHONE Numbers: (Home) _______________________ (Work) _____________________ (Cell) _________________________
7. EMAIL Addresses: (Home) _______________________ (Work) _____________________ (Other) _______________________
8. BIRTH PLACE and DATE: (City) ____________________________ (State) ___________ (Date) _______________________
9. WIFE’S FULL NAME: (First) _______________________ (Middle) ____________________ (Last) _____________________
10. OCCUPATION and ADDRESS: ___________________________________________________________________________
USUAL SIGNATURE _______________________________________________________________________________
We, the below signed Sir Knights vouch for the good character and Masonic standing of the petitioner and recommend his
admission.
____________________________________________________________________________________________________
NAME (Signature)
TITLE
COMMANDERY
____________________________________________________________________________________________________
NAME (Signature)
TITLE
COMMANDERY
Fees: $150.00. First year’s dues: $75.00. Make Check out for $225.00 to Piedmont Commandery No. 26
Per Bylaws: A separate check will be required AFTER Knighting, made out to Knights Templar Eye Foundation for
$30.00 (A separate check is required in order for you to receive credit as a tax deductible donation to KTEF, a 501c3
foundation).
(Petition Form P26; 5 Apr 2015)
PETITION
-OFCompanion _________________________________
For The Orders of Knighthood
Received:
AD
Elected:
AD
Red Cross:
AD
Malta:
AD
K.T.:
AD
Fees, Dues and KTEF Life Sponsorship
$150.00 Fee Required with Petition
Check #__________ Date _____________
$75.00 Dues Required with Petition
(Can be combined with Fee)
Check #__________ Date _____________
$30.00 to Knights Templar Eye Foundation
After Knighting
Check #__________ Date _____________