Lodge Dues & Contributions

Please list intended payments and contributions below:

PAYMENT (Dues) $
CONTRIBUTION (Jelen Fund) $
CONTRIBUTION (General Fund) $
CONTRIBUTION (DeMolay) $
CONTRIBUTION (Rainbow) $
TOTAL TO BE PAID* $
* Note: Please enter total amount both in the space provided on the PayPal form

Name:      Membership#:
Blue Lodge:

Contribution submitted by:
Phone #:         Email: 

Name either of the columns at the entrance to King Soloman's Temple?:  
(This question will help us prevent spam)

Brethren... Please honor your reservations

 

 

 

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