New Applicant
APPLICATION
FOR AUXILIARY MEMBERSHIP
Re-Enrollment
1.
Name______________________________________________________
2. Date of Birth________________ Age_____
3. Residence
Address_________________________________________________
City____________________ State/Prov.__________________________
ZIP______________ Telephone_____________________
Mailing Address (if
different)____________________________________________
IF YOU HAVE EVER BEEN A MEMBER OF THIS ORDER BEFORE, THE
FOLLOWING QUESTIONS MUST BE ANSWERED:
4. I formerly belonged to Auxiliary No.____ City___________
State/Prov._____
5. The reason for terminating my membership
was_____________________________
6. Have you ever applied for membership and were rejected? If
yes, where?_________
7. Do you have male affiliation in the Fraternal Order of
Eagles? Yes___ No ___
If yes, Name_________________ Relationship______________ Aerie
No.______
Having formed a favorable impression of your
Auxiliary, I, being of sound body and mind, over eighteen years
of age, believing in God, herewith present myself as a candidate
for membership and if accepted, I promise to abide by and obey
the Laws, Rules and Regulations of the Fraternal Order of
Eagles. I declare that I have not been rejected by an instituted
Auxiliary within the past six months, nor do I stand suspended
by an Auxiliary of the Fraternal Order of Eagles. I agree that
my answers to the questions are true and are without any
omissions. It is further agreed that in the event of my failure
to pay my dues to the Order on or before date due, all benefits
hereunder shall cease according to the Rules and Regulations of
the Fraternal Order of Eagles, and the local Auxiliary By-Laws.
Funeral benefits requirements are that you must be initiated
before passing your fifty-fifth birthday, and the benefits are
not effective until twelve months following initiation.
I understand that if I do not appear for initiation within
six months after my election to membership, my initiation fee
will be forfeited and my application for membership cancelled.
The initiation fee must be sent in to Grand Aerie immediately.
I fully agree that the Auxiliary shall not be required to
pay me any benefits unless approved by the Grand Aerie and by
the local Auxiliary By-Laws.
Applicant’s
Signature______________________________________________
Date_______________
First Proposer:
Auxiliary No.______
Name__________________________
Grand Aerie I.D. No.______________
Address________________________
City____________________________
State/Prov.___________ ZIP_______
Second
Proposer: Auxiliary No._____
Name_________________________
Address________________________
City____________________________
State/Prov.___________ ZIP_______
TO BE FILLED IN BY
SECRETARY
Application No._______________ In Auxiliary No.______ Fraternal
Order of Eagles
Amount Paid_________ Official Receipt No.________
Date Reported to G.A. Membership Dept.: Month_____ Day_____
Year_____
APPLICATION
APPROVED FOR
Beneficial or
Non-Beneficial
Membership
Application Submitted___________________
Elected to Membership__________________
Date Initiated__________________________
Secretary_____________________________
We, your Committee, have
interviewed the above-named applicant and recommend that she be
Accepted
Rejected
Re-Enrolled
for membership in this Order
FRATERNAL ORDER OF EAGLES
Auxiliary Initiation Fee Receipt
Received from__________________________ Amount Received
$___________
In payment of Initiation Fee in Auxiliary No.____ Received
by____________________________
Signature of Sponsor__________________________________ Date
_______ Detach and give this portion to
Applicant