Preliminary Questions

Please answer the following questions before begining the application.
Do you have a belief in a Supreme Being?
You must have a belief in a Supreme Being.
Are you over the age of 18?
You must be at least 18 years old to become a Freemason.
Are you an upstanding citizen?
You will be required to supply a national police check.
Are you available in the evening of the second Wednesday of each month?
We meet on the second Wednesday of each month.
Do you know any Freemasons?
It is ok if you don't. If you do, add them as your references.

Membership Application

For Lodge Allan Stuart 416 - Geurie
Please note: ALL fields are required unless otherwise marked.

Personal Particulars

Please Enter Given Names
Please Enter your Surname
Please Enter Preferred Name
Please Enter Qualifications
Please Enter Your Date Of Birth
Please Enter Your Place of Birth
Contacts (only one phone number and email required)
Invalid Phone Number
Invalid Phone Number
Invalid Phone Number
Please Enter Your Email

Occupation

If retired please mention below (e.g. Retired Accountant)
If retired leave Business details empty.
Please Enter Your Trade, Job or Profession Title
Please Enter Your Current Business Name
Please Enter Business Address
Please Specify Nature Of Business
Please Enter Business Post Code

Residential Details

List your residential addresses during the past three years beginning with your current address
Please Mention Your Current Address
You Have Not Reached Three Years of Residences

Details Of Previous Applications

Have you previously applied to become a Freemason or member of a similarly named Order e.g. Co-Freemasonry?
If so, give name and location of the Lodge or Order which you applied to join and the approximate date
Please Mention Name Of Lodge
Please Enter Address Of Lodge
Please Enter Applied date
What was the outcome of the application?
Please Enter Details

National Police Check

All candidates for membership are required to supply a National Police Check.
The application process can not move forward without it. If you do not add your certificate here you will be contacted for it before the process begins.
This can be done online at the above link. It is done through the New South Wales Police Force Community Portal.
The following should assist with the application:
  • The type of check required is a "Name and Date of Birth Check".
  • The purpose is "Probity"
  • The Reason is "Freemasons membership application"
The process will ask you for different forms of ID (e.g Drivers Licence and Passport). Some of the forms of ID can be verified online and you will recieve a digital certificate almost straight away.
You can upload that certificate here or you can supply it later.

Please note that you may be asked for further information

Referees

Give the names, addresses, and contact details of two persons, male or female (not your Nominators), to whom you are well known and from whom we may seek a reference.
Please Enter Referees 1's Name
Please Enter Referees 2's Name
Please Enter Referee 1's Address
Please Enter Referee 2's Address
Please Enter Referee 1's Phone
Please Enter Referee 2's Phone
Please Enter Referee 1's Email
Please Enter Referee 2's Email

Declaration

I declare that I have read the statement 'Membership Principles' and accept it as a condition of my membership. The information I have provided in this application is true and complete. I understand that the information provided by me in this application is for the purpose of registering my membership, if approved, on the membership databases of the United Grand Lodge of NSW and the ACT and any Lodges of which I may become a member. Registration is necessary to provide Grand Lodge with material to identify and record the Masonic status of its members, to determine the amount of Dues payable by each Lodge and to maintain a statistical base for membership surveys and the like. In the case of individual Lodges, the membership database, however maintained, contains information necessary for communication with members about Lodge Meetings and other matters. The information so provided is not available to third parties without the express consent of the member(s) concerned.

Sign in above box
Please Enter Your Name
Would you prefer to print and sign this form?
You will still need to enter your name in the Signature Name box above.
Your unsigned form will be sent to the Secretary and you will be contacted for the signed form before the application process can start.

Privacy Declaration

I declare that I have read of the contents of the 'Privacy Statement' of the United Grand Lodge of NSW & ACT as they apply to me, and that I understand the contents of this Statement.

Signature
Signature of Spouse/Partner