New Applicant  APPLICATION FOR AUXILIARY MEMBERSHIP  Re-Enrollment
1. Name______________________________________________________
2. Date of Birth________________ Age_____
3. Residence Address_________________________________________________
City____________________ State/Prov.__________________________
ZIP______________ Telephone_____________________
Mailing Address (if different)____________________________________________
IF YOU HAVE EVER BEEN A MEMBER OF THIS ORDER BEFORE, THE FOLLOWING QUESTIONS MUST BE ANSWERED:
4. I formerly belonged to Auxiliary No.____ City___________ State/Prov._____
5. The reason for terminating my membership was_____________________________
6. Have you ever applied for membership and were rejected? If yes, where?_________
7. Do you have male affiliation in the Fraternal Order of Eagles? Yes___  No ___
If yes, Name_________________ Relationship______________ Aerie No.______
    Having formed a favorable impression of your Auxiliary, I, being of sound body and mind, over eighteen years of age, believing in God, herewith present myself as a candidate for membership and if accepted, I promise to abide by and obey the Laws, Rules and Regulations of the Fraternal Order of Eagles. I declare that I have not been rejected by an instituted Auxiliary within the past six months, nor do I stand suspended by an Auxiliary of the Fraternal Order of Eagles. I agree that my answers to the questions are true and are without any omissions. It is further agreed that in the event of my failure to pay my dues to the Order on or before date due, all benefits hereunder shall cease according to the Rules and Regulations of the Fraternal Order of Eagles, and the local Auxiliary By-Laws. Funeral benefits requirements are that you must be initiated before passing your fifty-fifth birthday, and the benefits are not effective until twelve months following initiation.
    I understand that if I do not appear for initiation within six months after my election to membership, my initiation fee will be forfeited and my application for membership cancelled. The initiation fee must be sent in to Grand Aerie immediately.
    I fully agree that the Auxiliary shall not be required to pay me any benefits unless approved by the Grand Aerie and by the local Auxiliary By-Laws.
Applicant’s Signature______________________________________________ Date_______________

First Proposer: Auxiliary No.______
Name__________________________
Grand Aerie I.D. No.______________
Address________________________
City____________________________
State/Prov.___________ ZIP_______

Second Proposer: Auxiliary No._____
Name_________________________
Address________________________
City____________________________
State/Prov.___________ ZIP_______

TO BE FILLED IN BY SECRETARY

Application No._______________ In Auxiliary No.______ Fraternal Order of Eagles
Amount Paid_________ Official Receipt No.________
Date Reported to G.A. Membership Dept.: Month_____ Day_____ Year_____
APPLICATION APPROVED FOR
Beneficial or Non-Beneficial
Membership
Application Submitted___________________
Elected to Membership__________________
Date Initiated__________________________
Secretary_____________________________
We, your Committee, have interviewed the above-named applicant and recommend that she be
Accepted
Rejected
Re-Enrolled
for membership in this Order
FRATERNAL ORDER OF EAGLES Auxiliary Initiation Fee Receipt
Received from__________________________ Amount Received $___________
In payment of Initiation Fee in Auxiliary No.____ Received by____________________________
Signature of Sponsor__________________________________ Date _______

Detach and give this portion to Applicant