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Unique IDRegistration Date MM slash DD slash YYYY RegistrantRegistrant's Name(Required) First Middle Last Suffix Cell Phone(Required)Email(Required) Mailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Your Masonic AffiliationYork Rite Affiliation(Required)PLEASE CHECK ALL THAT APPLY. Guest Master Mason Royal Arch Mason Cryptic Mason Knight Templar DignitaryNot a DignitaryGrand Master of MasonsGeneral Grand High Priest or RepresentativeGeneral Grand Master or RepresentativeGrand Master of Knights Templar or RepresentativeRegional Deputy General Grand High PriestRegional Deputy General Grand MasterDepartment CommanderHead of a Masonic Family BodyGrand Lodge OfficeChoose Your Current Grand Lodge OfficeNot Currently ServingCommittee MemberAppointed OfficerPast Grand MasterGrand SecretaryGrand TreasurerJunior Grand WardenSenior Grand WardenDeputy Grand MasterGrand MasterGrand Chapter OfficeNot Currently ServingCommittee MemberAppointed OfficerPast Grand High PriestGrand SecretaryGrand TreasurerGrand ScribeGrand KingGrand High PriestGrand CouncilNot Currently ServingCommittee MemberAppointed OfficerPast Grand Master (Cryptic)Grand RecorderGrand TreasurerGrand Principal Conductor of the WorkDeputy Grand MasterGrand Master (Cryptic)Grand CommanderyNot Currently ServingCommittee MemberAppointed OfficerPast Grand CommanderGrand RecorderGrand TreasurerGrand Captain GeneralGrand GeneralissimoDeputy Grand CommanderGrand CommanderJurisdiction or Organization(Required)Choose Your Jurisdiction or OrganizationAlaskaColoradoIdahoMontanaOregonWashingtonWyomingGeneral Grand ChapterGeneral Grand CouncilGrand EncampmentOther (Not Listed)OrganizationI Intend to Participate In:(Required) Chapter Session Council Session Commandery Session Scottish Rite First Degree Number in Your Party (Including You)(Required)Note - Only one York Rite Mason per registration.OneTwoMoreSpouse/Guest(s)Spouse/First Guest First Middle Last Cell PhoneEmail This field is hidden when viewing the formYork Rite LeadershipPlease choose if they're attending York Rite Leadership.AttendingNot AttendingMore GuestsNameRelationshipCell PhoneEmail Add RemoveMealsFriday Only RegistrationLunch - Sandwich (Spicy Pastrami or Chicken Caprice); Banquet - Backyard Barbecue Price: QuantityPlease enter a number greater than or equal to 0.Subtotal $0.00 Friday Banquet & Saturday Lunch OnlyBanquet - Backyard Barbecue Saturady Lunch - Street Tacos Price: QuantityPlease enter a number greater than or equal to 0.Subtotal $0.00 Two Day RegistrationFriday Lunch - Backyard Barbecue Banquet - Backyard Barbecue Saturday Lunch - Street Tacos Price: QuantitySubtotal $0.00 Scottish Rite First DegreeSaturday Dinner - - First Degree Presentation Price: QuantitySubtotal $0.00 Conference FeesPayment(Required)Please select how this is paid.Credit Card OnlineBy CheckLate Fee (After October 2nd)(Required) Price: Convenience Fee $0.00 Total CAPTCHAPayPal