Application Please complete the following form for review District Grand Lodge of KwaZulu-Natal To be filled up in by the Applicant Surname Forenames in Full Date of Birth Home Address and Suburb Area Code Contact Details Cell Home Work E-mail Address Profession/Occupation/Trade Company Name Company Address Nationality If not a South African National, have you got a Permanent Resident Status? YesNoN/A Do you have a criminal record? YesNo Is your application voluntary? YesNo Do you have your own transport? YesNo For your review and acceptance: I accept that my obligations as a Freemason would include an overriding duty to obey the laws of any country to which I may be subject YesNo I confirm that I do not anticipate or seek any preferment or financial benefit as a consequence of becoming a member of the Craft YesNo I understand that I may freely declare my membership of the Order on any occasion where I can be seen not to be pursuing any business, professional or personal advantage YesNo I have never been convicted by a Court of any offence TrueFalse I have never been the subject of a finding of dishonest or disgraceful conduct TrueFalse I have never been disciplined by any professional, trade or other tribunal TrueFalse I am not awaiting the outcome of proceedings against me before a criminal court or a professional, trade or other tribunal TrueFalse I am not to the best of my knowledge, the subject of any criminal, professional, trade or other investigation TrueFalse I am not and have not been in any way connected with any organisation which is quasi-Masonic, imitative of Masonry, or regarded by the Grand Lodge as irregular or as incompatible with the Craft TrueFalse Why are you interested in becoming a Freemason? I declare the above to be correct and true.