Lodge Name and Number
 
 Please complete "if" attending...
 for VIP badges and  it also helps plan for food and drinks.

 Worshipful Master
 

 Senior Warden
 

 Junior Warden
 

 Secretary
 

 Treasurer
 

 Lodge Contact Person
 
 Phone Number
 

 District Deputy Grand Master
 or any other
 Grand Lodge Officer attending.
 

 Number of Non-Shriners
 "Lodge Member's who will be attending?
 

 Yes we plan to attend the MM Degree
 

 Yes we will field a Chili Cook Off Team and we are registered.
 

 Total Number of Guests we may expect?
  (Please be accurate, we want to make sure you get fed-:)