THE SOVEREIGN MILITARY ORDER
OF THE TEMPLE OF JERUSALEM
Priory of St. Michael & St. George of New York City

APPLICATION FOR ADMISSION
The Sovereign Military Order of the Temple of Jerusalem is a Christian Order open by invitation only.

 (Please print out, fill out as completely as possible, and mail to the address at bottom)

1) Family name:

2) Given Names:

3) Titles of Nobility & Origin:

4) Honorary titles:

5) Decorations:

6) Memberships in other orders of chivalry;

7) Academic titles & University:

8) Military rank, branch & status:

9) Professional titles:

10) Profession & firm:

11) Home address:

12a) Home tel.: 12b) Office tel.: 12e) E-mail:

12c) Home fax: 12d) Office fax:

13) Decorations:

14) Society and club memberships:

15) Date of Birth: 16) Citizenship:

17) Religion 18) Parsonage:

19) Marital status, spouse & date of marriage:

20) Children:

Please add an informal Curriculum Vitae. If desired, Genealogical information may be furnished. Please also include a recent photograph of yourself.

The undersigned engages himself (herself) of the duration of his (her) membership in the Order to be continuously reminded of the of the Order and his (her) fellow Knights, Dames and Companions.

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Signature Date       /       /

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Sponsor Signature

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Seconder Signature

Prior of the Priory of St. Michael & St. George:

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Signature Date       /       /

Grand Prior of the United States of America:

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Signature Date       /       /

Grand Chancellor of the United States of America

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Signature Date       /       /

Grand Secretary of the United States of America:

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Signature Date       /       /

Please mail completed application to:

SOVEREIGN MILITARY ORDER OF THE TEMPLE OF JERUSALEM
Priory of St. Michael and St. George
Chev. Edmund Allen Voyer, GCTJ, GMTJ Prior
355 East 72nd Street
Apartment 2AB
New York City, NY 10021
Tel. (212) 407-0581

Non Nobis, Domine, Non Nobis, Sed Nomini Tuo Da Gloriam  ™


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