Grand Lodge of Massachusetts

93 Concord Avenue

Belmont, Massachusetts 02478

INSTALLATION NOTICE

Lodge:  ______________________________________________  # __________

City or Town:  ______________________________________________________

Day, Date and Time of Installation:  _____________________________________________

Name of Hall:  ________________________________________________________________

Location of Hall: ______________________________________________________________

                                                      (Street)(City/Town)

        PLEASE INDICATE IF YOUR INSTALLATION IS JOINT-YES (_) NO (_)

If your lodge wishes to have a specific member of the State Council present at your Installation

Ceremony as guest speaker, please indicate below:

Guest Speaker lst choice:  _____________________________________________________

Guest Speaker 2nd choice: _____________________________________________________

Submitted By:  ________________________________Title: _________________________                

                 

Telephone: ___________________________________

If this form is not returned by March 16, 2007 a State Officer will be assigned to your lodge Installation.