To the N.G.V.G. Officers and Brothers of the Loyal.........Lodge

No..............A.I.O.O.F. Of New Zealand.

Brothers,—Herewith I present my Card of Withdrawal from...............Lodge, No............of.................and respectfully ask to be admitted a member of your Lodge, by deposit of the same; (if an Ancient Odd-Fellow, as an Ancient Odd-Fellow).

My residence is................; my age............. years; my occupation is..............; born in.................

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.