ANSAR UNIFORMED UNITS’ MEMBERSHIP REQUEST
To the Ansar Shrine Council of Unformed Units:
I hereby make application for membership in a Uniformed Unit of Ansar Shrine and submit the followingfor consideration:
(Use this area if you currently do not belong to a uniformed unit)I HAVE NO PRIMARY UNIT NOW AND AM APPLYING FOR:
(Use this area if you want to transfer primary membership to another uniformed unit)My current unit is: I want to change it to:
Name:
DOB:
Address:
Email address:
Spouse's name:
Phone number:
Employer:
Occupation:
Work phone:
MILITARY SERVICE: YesNo
(For Legion of Honor applications, upload a copy of your Dept of Defense Form DD-214 here)
By signing I further submit that I will abide by the rules and regulations of the Ansar Shrine Council of Uniformed Units and with the Constitution and By-Laws of the uniformed unit of application. I will properly care for Ansar property and upon request will return any property issued to me for parade and/or other uses. I understand it is possible to be a participating member of other units; however, I will parade with my primary unit and will have voting rights determined by the By-Laws of each unit. I am a member in good standing of Ansar Shrine in the city of Springfield, Illinois, USA.
For U/U Use Only: (___) Elected (___) | Rejected Date: ________________ Initials: _______________
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Document Name: ANSAR UNIFORMED UNITS’ MEMBERSHIP REQUEST
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