Application

Contact Information

Name*

First Middle Last Suffix

Preferred Name

Address*

Address 2*

City*

State*

Country*

Phone*

Email*

Birthdate*

MM

DD

YYYY

Is this a Parent's email*

Yes
No

I consent to being contacted by DeMolay International for the purposes of potential membership and receiving information about upcoming events

Yes

Additional Information

School Attending*

Grade*

Favorite School Subject(s)*

Hobbies/Interests*

Clubs, Organizations*

Church/Place of Worship*

References

List 2 friends (your age) you have known for one year

Friend 1*

First Last

Friend 1 Email*

Friend 1 Phone*

Friend 2*

First Last

Friend 2 Email*

Friend 2 Phone*

Parent / Guardian Information

Parent / Guardian Name*

First Last

Parent / Guardian Name

First Last

Is your parent/guardian a Senior DeMolay?*

Yes
No

If Yes, where was your parent/guardian a DeMolay?

Is your parent/guardian a Mason?*

Yes
No

If Yes, where is your parent/guardian a Mason?

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:_____________________________________________________

Application Form

Contact Information

Additional Information

References

Parent / Guardian Information

Signature