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DISPENSATION TO CONTINUE A LODGE WITH LESS THAN FIVE SUBSCRIBING MEMBERS

Please read the relevant section before completing this Form

Please check that you have supplied all the correct information before clicking the 'Submit' button at the foot of this page (you can delete and insert text as normal in any section).
However, please note that clicking the 'Reset' button clears ALL the fields in this Form.
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
Number of subscribing members shown on the latest Grand Lodge return
  
Actual number of subscribing members (if different)
  
Number of new Candidates anticipated over the next year
  
Number of subscribing members anticipated on next Grand Lodge return
  
Special circumstances warranting the request for a Dispensation
Any additional Comments