MEMBERSHIP APPLICATION

                                                                               ORDER SONS OF ITALY

                                                                       MEMBERSHIP APPLICATION

                                                         Giuseppe Verdi Lodge 1441   Sparks, Nevada

MEMBER LAST NAME:________________________

 MEMBER FIRST NAME: ___________________

ST. ADDR:__________________________________

 CITY:____________ STATE:______________ ZIP: ______________

TELEPHONE NUMBER: (       ) -______________________ 

1. I have never belonged to any Lodge of the Order. ( If this is not true, fill the following two lines. )

I have been a member of Lodge from which I was terminated

on ___/___/___ for______________________________________.

2. My occupation is( or if retired was )

________________________________ 3. I am: Single___ ; Married___ and my spouse name

is:______________________________

I have children whose names

are :____________________________________________________

4. I am ___, am not___ of Italian descent. My spouse is___, is not___ of Italian descent.

5. Explain source of Italian descent :

 

6. I know of no reason why I should not qualify to become a member of this Order.

I do solemnly declare and promise to accept and respect the principles upon which the Order Sons of Italy in America is based; the laws of the Supreme Lodge, of the Grand Lodge, and of my Lodge. I promise to be bound by the deliberations of the majority; to obey the orders of the National President, the State President, and the President of my Lodge and support the charitable endeavors of the Order. I promise to obey, uphold and defend the laws and the Constitution of the United States of America.

SIGNATURES -

Applicant  __________________________________

State Financial Secretary  ______________________

Date ___/___/___

 

 PAYMENTS TO BE MADE BY APPLICANT

Applicant Admission Fee............$

 Annual Dues…………$

 Total Payment Due $ _____

To apply for membership: 1- Print this form; 2- Complete all requested data; 3-Bring this completed form and a check to the next monthly meeting and give to Shirley.