Form

Certificate of Election
Chapter*
Date of Election
- Month - Day Year
at
/ Hour Minutes
Term Starts
- Month - Day Year
at
/ Hour Minutes
Term Ends
- Month - Day Year
at
/ Hour Minutes
When you have completed the following sections, please click the submit button. If you did not elect a councilor position, please enter "None" for their first and last name.
Master Councilor Information
MC Last Name*
MC First Name*
MC E-mail
MC Address
MC City
MC Zip Code
MC Phone
Senior Councilor Information
SC Last Name*
SC First Name*
SC Email
SC Address
SC City
SC Zip Code
SC Phone
Junior Councilor Information
JC Last Name*
JC First Name*
JC Email
JC Address
JC City
JC Zip Code
JC Phone
Scribe Information
Scribe Last Name
Scribe First Name
Scribe Email
Scribe Address
Scribe City
Scribe Zip Code
Scribe Phone
Is the Scribe an Advisor?

Yes No
Chapter Chairman Information
Chm Last Name*
Chm First Name*
Chm Email
Chm Address
Chm City
Chm Zip Code
Chm Phone
Chapter Advisor (Dad) Information
Dad Last Name*
Dad First Name*
Dad Email
Dad Address
Dad City
Dad Zip Code
Dad Phone
Chapter Information
Meeting Place*
Meeting Address*
City*
Zip Code*
Meeting Nights*
Meeting Time*
# Active Advisors*
# Active DeMolay*
Installation Information
Installation Location*
Installation Date
- Month - Day Year
at
/ Hour Minutes
Installation Time*
Should be Empty:

Master Councilor Information