DISPENSATION FOR THE PROPRIETOR / MANAGER OF LODGE PREMISES TO HOLD OFFICE IN THE LODGE

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YOUR DETAILS
Forename(s)
Surname
ELPGL computer number (if known)
Office (if not Secretary)
e-mail address
 
YOUR LODGE DETAILS
Name
Number
Regular meeting place
 
DISPENSATION REQUIREMENTS
Details of the Proprietor / Manager of the property where the Lodge meets
Forename(s)
Surname
ELPGL computer number (if known)
Membership
Position and responsibilities relative to the Lodge premises
Proposed Office in Lodge
Special circumstances warranting the request for a Dispensation
Investiture to take place on:
  
   
Any additional Comments