∵Printed Forms of the following Schedules can be obtained from the District Secretary.

Schedule A.

Schedules.

Notice of Resolution Appointing Trustees.

At a regular meeting of Court_______No. Ancient Order of Foresters, held at the Court-room

, _______it was resolved by a majority of the Members present and entitled to vote that^*_______be the Trustees of this Court. ^†

Schedule B.

Application for a Dispensation.

To the D.C.R., Officers, and Delegates of the Auckland

District.

At a regular meeting of Court________No. ________, held on the________day of________18________, it was resolved that a Dispensation be applied for, to open a Court at________, in the Colony of New Zealand, to be called Court________No. ________, page 48

Schedules.

to be opened on________the________day of 18________, and to be held every alternate from that date

Schedule C.

Memorandum of agreement made and entered upon this________day of________18________,________between of________, in the Colony of New Zealand, Surgeon, of the first part, and aforesaid, the Trustees of Court,________No. ________, of the Ancient Order of Foresters, a branch of the Auckland District, duly registered.

Whereby the said________having been duly elected Surgeon of the said Court, and in consideration of the salary hereafter mentioned to be paid to him quarterly, the aforesaid________Surgeon, hereby agrees to perform the several duties pertaining to the said office of Surgeon as set forth in the By-laws of the Court, to be subject to the penalties therein set forth for a breach of the said By-laws, ________as Trustees hereby covenant with the aforesaid________Surgeon to pay or cause to be paid in consideration of the faithful discharge of his Medical duties as presented in the said By-laws, a salary of________per [unclear: annum] for each and every member who shall be financial on Quarter-night.

Schedule D.

Age,

Name,

Occupation,

Married or Single,

Residence,

What is your Wife's name?

What is your Wife's age?

What has been the state of your Wife's health these last two years?

What has been the state of your health these last two years?

What was the nature of your last illness?

Have you, or any of your family been subject to Ruptures, Spitting of Blood, Asthma, Gout, or Rheumatism?

Do you know of any hereditary disease to which you may be liable?

Have you been refused admission into any Society in consequence of ill-health or otherwise? page 50

Schedules.

Are you aware of any circumstances which in justice and fairness you ought to communicate to the Society, either in regard to your own or Wife's (if any) state of health which, on reference to the Rules of such, might raise a question as regards your eligibility?

Name it,

Are you aware that if at any time hereafter it should be proved that the answers above given are not correct, you will expose yourself to the liability of being expelled from the Society?

And I hereby agree that this Declaration shall be the ground of Contract between the said Court and myself, and any of the statements herein contained be not true, the sum already paid, or any further sums that may be paid by me to the said Court shall be forfeited, and myself deprived of all benefits or advantages from the said Court and the Order.

And I further declare that I will conform to and abide by all the Rules of the Court and of the Order now in force, or hereafter to be enacted; or submit to the penalties therein contained.

As Witness my hand this_______day of_______18