Application Form for Exaltation - Manchester Epworth Chapter No 3921 (Internet Chapter)

This application form provides information required from applicants for being Exalted at Manchester Epworth Chapter No. 3921 (Internet Chapter), Province of East Lancashire, Supreme Grand Chapter of England.

Please ensure that you have read the “How to Join the Lodge” page before making your application.

Please note that all applicants are required to pay the Exaltation fee of 20.00 GBP within 14 days of making the application. This will be refunded if the application is refused.

Applicants are required to pay the SGC Exaltation fee (currently 42.30 GBP).When you click the “SUBMIT” button to commit the form an email will be sent to you in HTML format. If you do not receive a personal reply from us within 48 hours please send us an email

If you have any problems with the form please contact the webmaster

Required fields are marked with an *

I confirm that I have read the guidance notes for application.*

Personal Details

Title*

Family Name*

Given Name(s)*

Familiar Name by which you prefer to be addressed*

Date of Birth (dd/mm/yyyy)*

Home Address data
Home Address line 1*

Home Address line 2

Home Address line 3

Home Town or City*

Home County, State or Region*

Home Postal Code or Zip Code

Home Country*

Contact details
E-mail address*

Confirm E-mail address*

Home telephone (+ country code)*

Mobile Phone

Current/Former Employment (even if retired)
Job title, description, occupation.*

Employer's Name*

Please enter who you are employed by or enter "Retired" if so.
Address line 1

Address line 2

Address line 3

Town or City

County, State or Region

Postal Code or Zip Code

Country

Work telephone (+ country code)

Masonic Details

Date of Raising (dd/mm/yyyy)*

Craft Rank.

UGLE Grand Lodge Certificate No

Please enter the details of ALL lodges that you are now a member or HAVE been a member. There are 3 spaces below for your chapters. If you are a member of more than 3 you will be able to add them to the registration form P that will be emailed out to you after completion of this application form.

Lodge 1
Lodge Name *
Lodge Number (if applicable)
Province/District
Grand Lodge
Date Joined (dd/mm/yyyy)*
Date Left (dd/mm/yyyy)

Lodge 2
Lodge Name
Lodge Number (if applicable)
Province/District
Grand Lodge
Date Joined (yyyy-mm-dd)
Date Left (dd/mm/yyyy)

Lodge 3
Lodge Name
Lodge Number (if applicable)
Province/District
Grand Lodge
Date Joined (dd/mm/yyyy)
Date Left (dd/mm/yyyy)

Internet Chapter Members
Internet Chapter members you know:
Proposer
Seconder

Supplemental Questions

Where did you hear of Internet Chapter

I agree to receive email from Internet Chapter*
I have read the Data Protection Notice and Policy documents from Internet Chapter*

Should you, as a result of the data that you have submitted, be eligible to join Internet Chapter, we will send you, by email, an official Supreme Grand Chapter of England (SGC) Registration Form P. You must complete and sign a paper copy of this and then return it to the assistant secretary by post (UK only), airmail or Fedex.

If you are a member of a Chapter that is not under the jurisdiction of SGC your data will be submitted to SGC to ascertain that the Chapter is under a jurisdiction that is recognised by SGC.

Membership of more than one jurisdiction may preclude you from joining Internet Chapter if one or more of the jurisdictions of which you are a member is not recognised by SGC. You will be notified if this is the case.

You must also provide evidence that you are in good standing with every Chapter of which you are, or ever have been, a member. This may be a letter of clearance from the Chapter Scribe E, a demit certificate, or a copy of your dues card. A copy of your Grand Chapter certificate, if these are issued by your Grand Chapter, will also be required. These items can be sent as images by email if preferred

To join the chapter requires that you pay the sum of 15.00 GBP which is the current Joining Fee within 14 days of the application. This will be refunded if your application is refused. If not already a member of SGC, you must pay the SGC registration fee (currently 35.52 GBP). You must also pay your first year's annual Subscription (currently 55.00 GBP). All these payments should be made as soon as possible and must be paid before you will be permitted to join. If Sterling payments are not possible, International Money Orders will be accepted. The Chapter Treasurer is also able to process credit card payments on this web site HERE. In the event of any problem preventing you completing the joining process, and you do not become a member, the registration fee and annual subscription will be refunded in full.

The data that you provide is required by Supreme Grand Chapter of England but will only be held and used for the purposes of your membership of a private Chapter under the Constitution of the Supreme Grand Chapter of England. It will NOT be divulged to any third party unless exceptionally demanded by law.

Once the above have been formally concluded your application will be read out in open Chapter at the next Regular meeting, and then balloted at that meeting, which, if in your favour, will mean that you immediately become a member of the Chapter.

Following your admission to the Chapter you will be required to pay an Annual Subscription, currently 55.00 GBP, on the first day of March each year.

I confirm that I am currently a subscribing member in a Craft Lodge in UGLE or in a Grand Lodge recognized by UGLE.*

Please confirm that you have read the notes above by checking this box.*

Remember to pay your Chapter joining fees HERE after you have submitted the application form.