FOURTH DEGREE MEMBERSHIP APPLICATION:

Membership Applications (Form 4) may be obtained from any Assembly, Council or the
Master of the Indiana District. An application must be completed in full and signed by the
following: Candidate, Proposer, Faithful Navigator, Faithful Comptroller and the Council
Financial Secretary. Failure to obtain all necessary signatures will delay the processing of
the application. IMPORTANT: The application Form 4 (all copies of Form 4) should be
attached to the completed reservation form provided, along with a check payable to:
Charles Whitcraft. In the memo Master Indiana District and send to:

Norman Stoffel, PSD
Secretary – Indiana District
1121 North LaFontaine
Huntington, IN 46750-1817

Deadline for submitting application/registration is September 1, 2014
PLEASE NOTE: NO REFUNDS WILL BE MADE AFTER THIS DATE

Reservation forms should be submitted by every Candidate or Sir Knight attending this
Exemplification. This will help us to adequately plan all the functions for the weekend. A
reservation form is attached to this notice. Please reproduce additional copies if needed.

EXEMPLIFICATION FEE:

The fee, set by the Supreme Council, for Fourth Degree Candidates is $70.00. This fee includes the following: a social baldric, lapel pin and one dinner ticket. The fee for members of the Clergy is $25.00. It is suggested that local assemblies assume the cost for their clergy members. This fee does not include the yearly dues payable to your Assembly.