Masonic Membership Application

The following form is for Masonic applicants only. A copy of your Lodge Notice is also required to complete the application. Lodge Notices can be mailed, faxed to the Membership Office: 61 2 92841999 or emailed to admin@nswmasonicclub.com.au

Postal Address: PO Box A1160, Sydney South, NSW 1235, Australia

Please use the Associate Application Form if you are not a Masonic applicant.

Membership Fee*

1 year (A$40 +$5) 3 year (A$120 +$5)

Title

Family name*

Given name*

Occupation

Residential address*

City*

Postcode*

Telephone*

Current Lodge

Lodge No. or Constitution

Business/postal address

Postcode

Telephone

Mobile

Email*

Date of birth*

dd/mm/yyyy

Proposer

Proposer No.

Seconder

Seconder No.

I hereby apply to become a member of the New South Wales Masonic Club, declare that I am over the age of 18 years and agree to abide by the rules and laws of the Club.

How did you hear about the New South Wales Masonic Club?

Referral Magazine Internet Other

Special interests

Print form to be faxed or mailed with cheque payment.

Submit form and pay by credit card online.

Online payments accept Visa, Mastercard and Bankcard only. For payment by Diners Club or AMEX please contact the membership office - 61 2 9284 1006

* Fields marked with asterisk are compulsory.