FORM 7 

(Section 358) 

APPLICATION FOR AFFILIATION 

To the Worshipful Master, Wardens and Brethren of ___________________________________ Lodge, No. __________
_
on the register of the Grand Lodge of A.F. & A.M. of Canada in the Province of Ontario.
I, (Full Name)___________________________________________________ , of the ___________________________
_ 


of _____________________________________ and Province of Ontario, born (year-month-day) __________________
_
being a Mason, and desirous of becoming a member of __________________________________Lodge, No. _________
_
do declare as follows:


I am not in debt to any lodge for dues or otherwise.
I was initiated, passed and raised in ____________________________ Lodge, No. ____ at _______________________
_
under the jurisdiction of the Grand Lodge of ________________________________________, and I am in good standing.
I am (or was last) a member of __________________________________ Lodge, No. ___________
_
My Grand Lodge Certificate Number is ________________________________________________
_
I now reside at ___________________________________________________________________________________
_
City __________________________________ Postal Code ________________ Tel:____________________________
_


I have resided, during the year immediately preceding the date of this application, at the following addresses:


Dated at ___________________________________ this _________ day of ___________________ A.D. ___________

 _________________________________________ 
Recommended by ______________________________________ Signature in full 

Affiliation fee must accompany the form. 

In consideration of your receiving this Application for Affiliation, I consent to investigation being made from any source 
relating to my qualifications for membership in the Masonic Lodge to which this application is directed. 

I also release the lodge, each of its members, and the Grand Lodge A.F. & A.M. of Canada in the Province of Ontario and 
each of its members, from all claims which I may have arising from the investigation of my qualifications, or my rejection, if 
such should occur. 

I acknowledge and agree that all information relating to my application, investigation, acceptance or rejection, shall remain 
confidential between me and the Masonic Order. 

I further agree and consent to the transmission of my name, address, age, occupation and any other personal information set 
out on this form, by email or any other electronic means. 

I further acknowledge and agree that this application and notice of rejection thereof, if such should occur, may be retained by 
the Grand Lodge of A.F. & A.M. of Canada, in the Province of Ontario in a central database. 

(Signature)