Lodge Change of Address Form

Please fill out this Change of Address Form completely. It is a pleasure to work with you in this age of computers and hope that this form will be easier for all our Secretaries.

Your Name:

Your E-Mail Address :

Lodge Name and Number:

Location of Lodge:

Please enter all the information below:

Change # 1

Members Full Name#1: Membership Number#1:

Old Street#1: Old City#1: Old Zip#1:

New Street#1: New City#1: New Zip#1:

Change # 2

Members Full Name#2: Membership Number#2:

Old Street#2: Old City#2: Old Zip#2:

New Street#2: New City#2: New Zip#2:

Change # 3

Members Full Name#3: Membership Number#3:

Old Street#3: Old City#3: Old Zip#3:

New Street#3: New City#3: New Zip#3:

Please fill out a new form if you have more than three address changes.

Thank you for taking the time to fill out this change of address form. We are sure that you have found this to be much easier in submitting than before. If you would like to make any suggestions or comments please do so.

Any Comments:

Note: In the event that your Browser does not send the information that you filled in, please e-mail the information to: Data Processing Dept., Grand Lodge of Louisiana at (erin@la-mason.com). Thank You.

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Phone: 318-443-5610 · Fax: 318-443-5759 · Email the Grand Lodge

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