GOLD KEY AWARD

(NOMINATION FORM)

 

Qualifying characteristics, nominating procedures and limitations of this Award will be found in 43.04 of the Grand Chapter Constitution and Regulations.

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NAME OF NOMINEE ______________________________________________ Wife ____________

            Address ____________________________ City ________________ St. ______ Zip _______

            Phone (Home) _______________________ (Business)________________________________

 

Masonic Lodge __________________________ No _____ Location ___________________________________________

                Raised ______ WM _____ DDGM ________ Grand Lodge___________________________________________

                Honors _____________________________________________________________________________________

 

Royal Arch Mason_______________________No _____ Location ____________________________________________

                Exalted _____ HP ______ DDGHP _____Grand Chapter_____________________________________________

                Honors _____________________________________________________________________________________

 

Royal & Select Masters ___________________No _____ Location____________________________________________

                Greeted _____ IM ______ DDGM _______ Grand Council ___________________________________________

                Honors _____________________________________________________________________________________

 

Commandery_______________________________ No _____ Location ________________________________________

                Knighted _____ EC _____ DDGC _______Grand Commandery _______________________________________

                Honors _____________________________________________________________________________________

 

Attendance at Meetings (On a scale of One to Ten)

                                                Stated                    Called                    Degree Work                         Special Functions

                Lodge                     _____                    _____                    ___________                      _______________

                RAM                      _____                    _____                    ___________                      _______________

                R&SM                   _____                    _____                    ___________                      _______________

                KT                          _____                    _____                    ___________                      _______________

 

Current Office      (Elected, Appointed or Regular Pro Tem)

                Lodge _____________________________________ RAM ___________________________________________

                R&SM ______________________________________ K ____________________________________________

                Other_______________________________________________________________________________________

 

Services Performed on a Regular Basis

                Lodge _____________________________________ RAM ___________________________________________

                R&SM ______________________________________ KT ___________________________________________

                Other_______________________________________________________________________________________

 

Other Masonic Related Bodies

                AAONMS _____                 GROTTO _____                  KYCH _____               MSRICF _____           TC of L _____

                AASR ____                          HRAKTP _____                  M&W_____                   Red Cross ____         YRCollege___      AMD ___                                KM _____           

                Other_______________________________________________________________________________________

 

Service to Youth (Fill in "P" if Present, "F" if Former)

                DeMolay __________       Job's Daughters _____                       Rainbow _____                   Church _______

                Little League     _____        Boy Scouts ________

                Other_______________________________________________________________________________________

 

 

NAME _________________________________ Chapter ________________________ No ________

                        (Name of Nominator)