Internet Lodge 9659

Application Form

This application form provides information required from applicants for joining Internet Lodge No. 9659, Province of East Lancashire, United Grand Lodge of England.

Applications for membership are welcome from any Freemason who is a member of a Grand Lodge that is recognised by the United Grand Lodge of England.

Please ensure that you have read the "How to Join the Lodge" page before making your application.

Please note that all applicants are required to pay the joining fee of 50.00 GBP within 14 days of making the application. This will be refunded if the application is refused.

Applicants from constitutions other than UGLE are also required to pay the UGLE registration fee (currently 70.80 GBP).

Please complete all required data if applicable. An asterisk '*' indicates optional data. Further notes are provided at the bottom of the page.

When you click the "SUBMIT" button to commit the form an email will be sent to you in HTML format. It is necessary that you click on the hyperlink in the email to confirm your application. this measure is to prevent web bots from inundating us with rogue forms.

If you do not receive a personal reply from us within 48 hours please send us an email

If you have any problems with the form please contact the webmaster at

Personal details

Family Name:  
Given Name(s):  
Familiar name by which you
 prefer to be addressed:
Date of Birth(ddmmyyyy):  
* Title (Mr, Senor, Herr, Dr, Prof, etc):  

Home address data

Address line 1:  
* Address line 2:  
* Address line 3:  
Town or City:  
County, State or Region:  
Postal Code or Zip Code:  

Contact details

E-mail address:  
Home telephone (+ country code):  
* Personal mobile (+ country code):  

Current/Former Employment (even if retired)

Job title, description, occupation:
(please provide as much
information as possible)
Employer's Name:  
Address line 1:  
* Address line 2:  
* Address line 3:  
Town or City:  
County, State or Region:  
Postal Code or Zip Code:  
* Work telephone (+ country code):  

Masonic Details

Date of Initiation (ddmmyyyy):  
* Date of Passing (ddmmyyyy):  
Date of Raising (ddmmyyyy):  
Masonic Rank (MM, PM, PPJGD, PGDC):  

Craft Lodge Membership

  Lodge 1 Lodge 2 * Lodge 3 *
Lodge Name:      
* Lodge Number
(if applicable):
* Province/District
(if applicable):
Date joined (ddmmyyyy):      
Grand Lodge Name:      

Internet Lodge

  Name 1 Name 2
* Names of Internet Lodge members you know:    


  1. An asterisk (*) identifies optional data. All other data are required if applicable.
  2. If there is insufficient space please continue on a separate document using the same headings. The more information you can supply, the easier and quicker it will be for us to process your application.
  3. Should you, as a result of the data that you have submitted, be eligible to join Internet Lodge, we will send you, by email, an official United Grand Lodge of England (UGLE) Registration Form P. You must complete and sign a paper copy of this and then return it to the assistant secretary by post (UK only), airmail or Fedex.
  4. If you are a member of a Lodge or Lodges that are not under the jurisdiction of UGLE your data will be submitted to UGLE to ascertain that the Lodge or Lodges are under a jurisdiction that is recognised by UGLE.
  5. Membership of more than one jurisdiction may preclude you from joining Internet Lodge if one or more of the jurisdictions of which you are a member is not recognised by UGLE. You will be notified if this is the case.
  6. You must also provide evidence that you are in good standing with every Lodge of which you are, or ever have been, a member. This may be a letter of clearance from the Lodge Secretary, a demit certificate, or a copy of your dues card. A copy of your Grand Lodge certificate, if these are issued by your Grand Lodge, will also be required. These items can be sent as images by email if preferred
  7. To join the lodge requires that you pay the sum of 50.00 GBP which is the current Joining Fee within 14 days of the application. This will be refunded if your application is refused. If not already a member of UGLE, you must pay the UGLE registration fee (currently 70.80 GBP). You must also pay your first year's annual Subscription (currently 80.00 GBP). All these payments should be made as soon as possible and must be paid before you will be permitted to join. If Sterling payments are not possible, International Money Orders will be accepted. The Lodge Treasurer is also able to process credit card payments via the Web which you can do on this website or at In the event of any problem preventing you completing the joining process, and you do not become a member, the registration fee and annual subscription will be refunded in full.
  8. The data that you provide is required by United Grand Lodge of England but will only be held and used for the purposes of your membership of a private Lodge under the Constitution of the United Grand Lodge of England. It will NOT be divulged to any third party unless exceptionally demanded by law.
  9. Once the above have been formally concluded your application will be read out in open Lodge at the next Regular meeting, and then balloted (voted) on at the following Regular Meeting, which, if in your favour, will mean that you immediately become a member of the Lodge.
  10. Following your admission to the Lodge you will be required to pay an Annual Subscription, currently 80 GBP, on the first day of March each year.
I confirm that I have read the above notes and that I will, when requested, pay the required fees.

When you have completed the form you will be sent an email containing a link and the data that you have submitted. Please click on the link in the email. This will open your browser and confirm your submission of the application form.

Revised August 2015