Application - Be A DeMolay

Contact Information

Name*

First Middle Last Suffix

Preferred Name

Address*

Address 2*

City*

State*

Country*

Phone*

Email*

Is this a Parent's email*

Yes
No

Birthdate*

Shirt Size*

Additional Information

School Attending*

Grade*

Clubs, Organizations, Extracurriculars*

Favorite: (Answer at least 3)

Subject

Class

Teacher

Hobbies

Book

Movie

Video Game

App

Other

Other Information

Do you work?

Yes
No
Not Applicable

Where do you work?*

Do you believe in God or a Supreme Being/Deity?

Yes
No

My Parents/Guardians approve of me joining DeMolay and support me in my activities.

Parent / Guardian Name*

First Last

Parent Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Phone*

Parent Email*

Parent / Guardian Name

First Last

Parent Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Phone

Parent Email

Signature

This section will be used later. After submission, a local representative will get in touch with you. They will then print this and have you sign it.

By signing this petition, you are hereby agreeing to join DeMolay, and live by the virtues and precepts of love for parents, belief in a higher power, courtesy, comradeship, fidelity, cleanness, and patriotism.

DeMolay Sponsor ID:_____________________________________________________

DeMolay Sponsor’s Name:_____________________________________________________

DeMolay Sponsor Signature:_____________________________________________________

Parent/Guardian Signature:_____________________________________________________

Applicant Signature:_____________________________________________________