GRAND YORK RITE REGISTRATION FORM

Revised 03/2002

Name: _________________________________ Date: __________________

SECTION A: BALLOTS / VOTES / CREDENTIALS

Chapter Name: ____________________________________ No. ____________

Council Name: ____________________________________ No. _____________

Commandery Name: _______________________________ No. ______________

CHAPTER	COUNCIL	COMMANDERY
PRESENT ____ High Priest ____ King ____ Scribe PROXY For ____ High Priest ____ King ____ Scribe	PRESENT ____ Ill. Master ____ Dep. Master ____ Pr. Cond. Work PROXY For ____ Ill. Master ____ Dep. Master ____ Pr. Cond. Work	PRESENT ____ Commander ____ Generalissimo ____ Capt. General PROXY For ____ Commander ____ Generalissimo ____ Capt. General

*NOTE: The three (3) Principal Officers or their Proxies are required to present credentials in

order to receive a ballot.

____ Past High Priest

____Past Ill. Master

____ Past Commander

SECTION B: REGISTRATION /ATTENDANCE / ROLL CALL OF OFFICERS

CHAPTER	COUNCIL	COMMANDERY
____ Present Grand Officer Rank/Position	____ Present Grand Officer Rank/Position	____ Present Grand Officer Rank/Position
____ Past Grand Officer Rank/Position	____ Past Grand Officer Rank/Position	____ Past Grand Officer Rank/Position
PRESENT DISTRICT OFFICER District No. ____ ____ District High Priest ____ District Lecturer	PRESENT DISTRICT OFFICER District No. ____ ____ District High Priest ____ District Lecturer	PRESENT DISTRICT OFFICER District No. ____ ____ District Commander ____ District Inspector/Instructor

______NON--VOTING MEMBER

TOTAL CHAPTER BALLOTS TOTAL COUNCIL BALLOTS TOTAL COMMANDERY BALLOTS

_______ ______ ________