DISPENSATION FOR UNANTICIPATED CHANGE IN TREASURER

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YOUR DETAILS
Forename(s)
Surname
ELPGL computer number (if known)
Office (if not Secretary / Scribe E)
e-mail address
 
YOUR LODGE / CHAPTER DETAILS
Lodge or Chapter ?
Name
Number
Regular meeting place
 
DISPENSATION REQUIREMENTS
Details of proposed election meeting
  
   
Details of current Treasurer
Name in Full
ELPGL computer No: (if known)
Details of replacement Treasurer
Name in Full
ELPGL computer No: (if known)
Special circumstances warranting the request for a Dispensation
Any additional Comments