Initiation Report.pdf

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Initiation Report (Red Book)
INITIATION REPORT (RED BOOK)
Body Name:
Address:
Phone:
Email:
MAIL THIS
Grand Treasurer General
FORM TO:
Ordo Templi Orientis USA
P.O. Box 45139
Los Angeles, CA 90045
Date of Initiation:
Degree Initiated:
Use a separate form for each degree.
Minerval/Ist and IVth/PI may be combined.
Officers:
List Names
and Roles
C
A
N
D
I
D
A
T
E
1
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
C
A
N
D
I
D
A
T
E
2
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
C
A
N
D
I
D
A
T
E
3
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
C
A
N
D
I
D
A
T
E
4
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
C
A
N
D
I
D
A
T
E
5
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
C
A
N
D
I
D
A
T
E
6
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
C
A
N
D
I
D
A
T
E
7
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
C
A
N
D
I
D
A
T
E
8
Full Civil Name:
Address:
Time Initiated: Fees Paid: $
Back Dues: $ Dues Paid: $
Notes:
Use separate sheets for additional candidates
Total Fees Paid: $
Total Dues Paid: $
Amount Enclosed: $
Make checks payable to Ordo Templi Orientis USA .
Notes:
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