Scottish Rite 1st, 2nd, 3rd Degrees Registration
Phoenix, Arizona
Wednesday May 12, and Thursday May 13, 2010
Name: _____________________________________________________________________________ Master Mason: Yes □, No □
Masonic Title: _______________________________________________________________________________________________
Address:_____________________________________________________________ email:__________________________________
City:______________________________________________________________ State: __________________ Zip: ______________
Phone Day: ______________________________ Evening: __________________________ Mobile: __________________________
Lady Attending Dinner: Yes □, No □; Lady’s Name: ________________________________________________________________
Location is the El Zaribah Shrine
Events open to Master Masons Only, and
Dinners open to guests
(Please plan to bring your guest(s) to dinner – bus transportation from/to hotel provided)
(Entry to Degrees without dinner is the same price)
(Registration Closes May 1, 2010)
Wednesday – First and Second Scottish Rite Degrees (Dinner Included) Qty_______ @ $25.00 = $ ________
Thursday – Third Scottish Rite Degree (Cajun Dinner Included) Qty_______ @ $25.00 = $ ________
Total $________
Signature: __________________________________________________________________________ Date: __________________
Registration Closes May 1, 2010
We can charge your Consistory □ or you can register by Check □
If paying by Check – Make Check Payable to Phoenix Scottish Rite Bodies
Check Enclosed □ Amount $ _______
Mail to: 14001 North 7th Street, F-111 Phoenix, Arizona 85022
Phone: (602) 212-1073, x-203/204 / Email: PSRB_secretary@srmason-az.org / Fax: (602) 212-1076