Form 22

Name *

First Name

Middle Initial

Last Name

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Cell Phone

Name *

First Name

Last Name

Home Phone

Cell Phone

Email *

I qualify for the Past Master Councilors Meritorious Service Award for completing the following during my term in office as Master Councilor. *

Prior to my installation as Master Councilor I memorized the Master Councilor’s portion in the Ritual of Secret Work.

I presented, before my installation, in printed form (multiple copies for distribution to the entire membership) a planned program listing of all events and dates planned for my term of office.

At the beginning of my term (and within 10 days after installation) I sent my letter to the Executive Officer in my Jurisdiction my PMC-MSA Letter of Intent (MD Form 20) which included my term plan, term budget, statement that the ritual work has been memorized and other information that may be important. My letter of intent was countersigned by the Chapter Advisor.

Prior to the completion of my term I fulfilled the following. *

As Master Councilor I exemplified both degrees from the Ritual of Secret Work and that the ceremonies from the Ritual of Secret Work were given from memory

My Chapter held at least one (1) Social Service, Civic Service, Masonic Service, and a Fund-Raising activity during my term of office.

I provided public observance of each of the Obligatory Day that fell during my term of office.

I verified with my Chapter ‘Dad’ Advisor that all “Form 10” ‘s reporting all new initiates were submitted to Michigan DeMolay and DeMolay International within the ten (10) day requirement.

Suplumental Documentation

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Form 22 - PMC-MSA Letter of Intent