New Prospect Information Survey

Personal Information

Tell us about yourself!

Name *

First

Middle

Last

Preferred Name or Nickname (If Any)

Email Address *

Phone Number *

Phone Type *

Residential Address (Include Home/Apt Number, Town, Zip Code, etc) *

Date of Birth *

Driver's License number and Issuing State *

Please upload a photo of yourself. *

Select Image

Image must show your face.

Security Questions

Safety is one of our highest priorities.

Do you agree to having a background check done by the Lodge? *

Yes No

Other than minor traffic violations, have you ever been convicted of a misdemeanor? *

Yes No

If your answer was "Yes," what was that misdemeanor? *

Write "N/A" if you responded "No" to the previous question.

Other than minor traffic violations, have you ever been convicted of a felony? *

Yes No

If your answer was "Yes," what was that felony? *

Write "N/A" if you responded "No" to the previous question.

Character Reference #1 - Name *

Character Reference #1 - Phone Number *

Character Reference #2 - Name *

Character Reference #2 - Phone Number *

Character Reference #3 - Name *

Character Reference #3 - Phone Number *

Family Information

Tell us a little bit about your family.

Marital Status *

Have you had a conversation with your partner about joining Freemasonry, and if so, do they support you joining? *

How many children do you have? *

Do you know if you have any family members involved in Freemasonry? *

Professional History

Tell us a little bit about your usual vocation.

Current Employer *

Contact Information for Current Employer *

Have you served (or are you currently serving) in the United States Armed Forces? *

Yes No

Are you currently employed as a "First Responder?" (Law enforcement, firefighting, emergency medical services, etc). *

Yes No

Are you currently employed at a Public School? *

Yes No

Consent & Understanding

We like to make sure everything is above-board.

Do you understand and accept that Freemasonry accepts men of all races, creeds, and religions? *

Yes No

Do you understand that we are required to conduct a visit to your home as part of the process of joining, and we request that your significant other be present, if possible? *

Yes No

Do you understand that the process for joining is not given or bought, but earned, and this process can take several months? *

Yes No

Do you understand that if you are accepted for membership, there are fees for each degree which you must pay as you progress? *

Yes No

Do you understand that you will be required to pay yearly dues of $365 once you become a Master Mason? *

Yes No

Do you understand that you must invest time on a regular basis to progress through the degrees and for Freemasonry to be a benefit for you? *

Yes No

Do you understand that our lodge primarily meets on Monday nights at 6pm? *

Yes No

Reasons for Joining

Tell us a little about why you're interested in becoming a mason.

In your own words, why do you want to become a Freemason? *

How did you hear about Fort Worth Lodge? *

Why did you choose this lodge? *

Previous Experience

This section will help us learn how familiar you are with the process of becoming a member.

Have you visited any other lodges? *

Yes No

Have you petitioned for membership at any other lodges? *

Yes No

Are you a member of any fraternities (collegiate, social, or otherwise) or esoteric orders? *

Yes No

If your answer above was "yes," to which fraternities and/or orders do you belong?

Spiritual and Cultural Background Questions

This will let us know more about how to best accommodate you during your experience in becoming a Mason.

Do you believe in a "Higher Power" (or what some religions call God)? *

Yes No

Do you believe in the immortality of the soul? *

Yes No

Do you believe in the divine authenticity of the holy writings of your religion? *

Yes No