DISPENSATION TO SERVE AS MASTER OF TWO LODGES AT THE SAME TIME

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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 Installation Meeting
  
   
Details of Master Elect
Forename(s)
Surname
ELPGL computer number (if known)
Current office in Lodge
Explanation (if "Other" selected - above)
Special circumstances warranting the request for a Dispensation
Details of anticipated Master Elect's other Lodge
Lodge name
Lodge number
Province
Date he was Installed
Details of the other Lodge's Secretary
Forename
Surename
Address - line1
Address - line 2
Address - line 3
Post code
Additional information (if any)
Any additional comments