The Pamphlet Collection of Sir Robert Stout: Volume 17
[application form]
To the Officers and Members of the Loyal............ Lodge, No......, A.I.O.O.F. of New Zealand.
Gentlemen,—Having conceived a favorable opinion of Odd-Fellowship, I respectfully ask to be initiated into the Order, and become a member of your Lodge.
My residence is...........; my age is..............years; my occupation is......................; born in........................
If admitted, I promise obedience to the usages and laws of the Order and of the Lodge.