Valley of the Tri Cities, Transfer Petition

Ancient and Accepted Scottish Rite
of Freemasonry
Valley of the Tri Cities, Orient of Alabama
P. O. Box 56
Florence, Alabama
35631

Robert Chard, KCCH	John Hicks, Sr., 33°
General Secretary	Personal Representative
	of the SGIG
	In Alabama

Valley of _____________________________
Address _____________________________
_____________________________
_____________________________

Dear Brother Secretary,

Having permanent residence in the Valley of the Tri Cities, Orient of Alabama, I desire to transfer my membership to the Valley of the Tri Cities. I would appreciate you furninshing a certificate of Good Standing or Demit to:

Robert Chard, KCCH	Your Date of Birth ______________
General Secretary	Blue Lodge ____________No ____
Scottish Rite Bodies	Location _____________________
Valley of the Tri Cities	Wife's Name __________________
P. O. Box 56
Florence, Alabama, 35631

Sincerely and Fraternally,

Signature _______________________________________
Print Name _____________________________________
Street Address __________________________________
City/State/Zip ___________________________________
Phone Number __________________________________