New Member Form – Investigation Night Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastCell / Mobile Phone *Email *What Social Media do you use?FacebookInstagramX - (Twitter)Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeThis address will be used to send you Formal Elks Information by our Fremont Lodge #2121.Did you review the answers that were provided on the initial application with the interviewer?YesNoWere any of these questions unclear to you?YesNoIf Yes, do you have any questions about them?YesNoMany Fraternal Orders Offer Benefits, we do not... do you understand?YesNoMany Fraternal memberships offer insurance or other benefits. Do you understand that there are NO such benefits through the BPOE Elks Lodge. Nor are the Elks Permitted to use their membership in the order for business or commercial purposes.Five (5) Qualifications for Membership A Citizen of the United States of America Must be of Good Moral Character Must Believe in God (Does not matter which one) Not affiliated with the Communist Party I do not have a Felony on my Permanent Record You MUST Agree to ALL Above Do you subscribe to these membership requirements and agree to abide by them without reservation?YesNoDo you realize that this board has only an advisory capacity and the final approval of your application for membership in this lodge will be by secret ballot of the general membership?YesNoWe would like more info - and/or - We would like to volunteer with the noted programs:Member OnlySpouse OnlyBoth - Member & SpouseCharitiesBingoElks National FoundationMajor Project - Purple Pig / CHEMPILocal CharitiesYouth ActivitiesScoutingYouth SportsStudent of the MonthDrug AwarenessAmericanisimScholarship Program has more abide Lodge CommitteesMembership ProgramGovernment/Community RelationsHouse CommitteeVeterans ProgramsPublicityLodge Event ActivitiesAround the LodgeI am interested in becoming an OfficerI can help in the KitchenI can tend BarI am skilled in Building MaintenanceSubmit
