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Masonic Dues Card Verification

Please enter your current dues card information exactly as it appears on your card.

PART 1 — Grand Lodge Certification

Most Worshipful Prince Hall Grand Lodge, F. & A. M.

For (Grand Lodge / Jurisdiction) *

Grand Secretary Name *

PART 2 — Identification Card

This is to certify that the Brother named herein is a Master Mason in good standing

Brother (Full Name) *

Lodge Name *

Lodge No.

Lodge Secretary Name *

City, State *

Date Issued (Month/Day, Year) *

Card Void After (Month/Day, Year) *

Your dues card information is used solely for membership verification. It is kept secure and confidential.