Special Dispensation Request
Please send Special Dispensation requests 14 days or more before dispensation is required to allow appropriate processing time. Completed requests should be sent to the Grand Guardian. Applicable fees should be sent to the Grand Secretary.
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Today’s Date *
Bethel #: *
Name of Bethel Guardian: *
Address: *
City *
State *
Zip Code *
Phone: *
Email: *
Date of regularly scheduled meeting *
New meeting date *
At a regular meeting of our Bethel, a motion was passed to request a Special Dispensation granting the Bethel the privilege to: (Please select only one)
Special Dispensations falling under these categories require a $5 fee. Please send a check to the Grand Secretary
Clear selection
At a regular meeting of our Bethel, a motion was passed to request a Special Dispensation granting the Bethel the privilege to: (Please select only one)
Special Dispensations falling under these categories do not require a fee be paid.
Clear selection
Please provide further details regarding when, where and/or why the Special Dispensation is being requested.
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