NAME: First________________Initial_______Last_____________________

ADDRESS: Street:__________________________________________________

City:________________________State:________Zip:____________________

E-mail address:_________________________@______________._______

MEMBER OF: Lodge__________________________No.___________

City____________________State________________

SIGNATURE:_______________________________DATE______________

Your check for $15.00[USD] or $20.00 [Foreign]
makes you a member for the current year.
PRINT or write your name and address PLAINLY
and mail to:
Research Lodge No. 2 A.F. & A.M.
P.O. Box 13048
Des Moines, IA 50310
515/255/7600
Your dues for the current year plus $3.50 (postage) will bring you the current book
offering from Research Lodge plus 2 other books. A $40.00 value.