Shriners NextGEN

Shriners NextGEN

Shriners International Membership Department
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Country Code Area Code Phone Number
City, State *
Age *
Job Title *
Company Name *
Temple *
Shrine ID
Please list your current Shrine Position *
Please indicate your leadership qualifications to support your consideration. (Please check all that apply.) *

Temple Potentate Divan Officer Club/Unit President Club/Unit Officer
Please provide a history of your fraternal background and experience (including your Blue Lodge and other appendant bodies). Describe any leadership roles, projects, or events for which you have served. (150 words or less). *

0/150
Please provide a summation of any awards, accolades or recognitions you have received for fraternal service. (100 words or less.) *

0/100
Please select the three (3) areas below that you would note as your strongest skills. *

Membership Recruitment Membership Awareness Membership Retention Membership Engagement Social Media Financial Planning Leadership Experience Brand Awareness/Development Sales & Marketing Strategic Planning Human Relations Event & Meeting Design Millennials/Gen Z Nonprofit Management
Describe techniques have you used to recruit new members. (150 words or less) *

0/150
Please describe any unique experiences or anecdotes to provide perspective from your fraternal leadership experience. (100 words or less) *

0/100
Please describe any new events, clubs, and/or units that you have created that successfully engaged young members. (150 words or less) *

0/150
Describe how serving as a leader in your Shrine contributed towards the success in your career. (150 words or less) *

0/150
Please tell us what you enjoy most about being a Shriner. (150 words or less) *

0/150
Are you a legacy member? (A legacy member is one who has continued the family tradition of fraternal membership.) *

Yes No
If you answered yes above, please select your legacy member(s) from the list below. Hold the Ctrl Key to select more than one. (If you are not a legacy member, you can skip this question.)
Please upload a headshot photo of yourself. (Photo should be high quality of at least 1 megapixel and in .jpg or .png format)

Cancel of
By submitting this form, I agree to allow the use of my content, photo and likeness by Shriners International for purposes of the NextGEN program. *

I agree
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