ent000974-010

Application for Membership in LAS VEGAS, NEVADA, LODGE NO. 1468 Benevolent and Protective Order of Elks Brother- Mr JOHN F. MENDOZA of the United States of America .under the obligation of the Order, proposes for membership in this Lodge, QUESTIONS TO BE ANSWERED BY APPLICANT IMPORTANT! Applicant's name, complete address including P.O. box, rural route, street address. Zone No. (if any), and correct post office should be given. Your home address will be used as mailing address unless otherwise specified. J. Name- _ Occupation- Home Address- Business Address- -Telephone- -Telephone- 2. Sfafe the place and date of your birth. Answer: Born in City of Counfyof__ . ?╟÷ ?╟÷ ?╟÷* Sfafe of?╟? _, on the- -day of_ -in year s' Do you believe in the existence of God? Answer_ 4. Are you a Citizen of fhe United States of America? Answerer If foreign born, when and where were final naturalization papers issued? Answer _?╟÷?╟÷ 6. Are you willing to assume an obligation that (a) Will not conflict with your duties to yourself, or your family, or your religious or political opinions, and that (b) Will bind you to uphold the Constitution and laws of the United States of America? Answer _ 7. Are you now or have you ever been a member of the Communist party or directly or indirectly connected or affiliated with the Communist party, or with any organization or group advocating or believing in the overthrow of the government of the United States by force? Answer- 8. Have you ever pleaded guilty to, or been convicted of a felony? . . Answer _ If your answer is in the affirmative, state nature of crime, date and place of conviction, and sentence imposed. 9. If you have ever been discharged from the Armed Services of the United States or any of its Allies, state the character of the discharge received . Answer?╟÷?╟÷ 10. Do you anticipate any pecuniary benefits by becoming a member of this Order? . . . . Answer 11. Do you know of any physical ailment that might cause you to become a burden upon this Order? Answer?╟÷:?╟÷ 12. Have you ever been proposed for membership in any lodge of this Order, and if so, where and when and with what result? . . Answer _ _ ?╟÷ 13. Have you been a bona fide resident within the jurisdiction of this Lodge for the period of six months immediately preceding the date of this application? Answer 14. 1 understand and agree that the annual dues paid by me to your Lodge include the sum of $1.00, or any other sum that hereafter may be tablished by the Grand Lodge, to cover my subscription to The Elks Magazine. 15. Give references of at least two members of this Order, stating the name, home address, and business address of each. NAME HOME ADDRESS BUSINESS ADDRESS 16. Give the name of each place of residence you have had during the five years last preceding the date of this application, specifying date of each change therein, also the occupation followed by you in each place. PLACE OF RESIDENCE WHEN ESTABLISHED WHEN CHANGED OCCUPATION 17. Give the name and address of at least two citizens of any city in which you have resided during the last five years, where a lodge of this Order is located. NAME HOME ADDRESS BUSINESS ADDRESS The above blank must be fully filled out by the Proposer and the Applicant, and to be accompanied by an Application Fee of Dollars, or it will not be considered. Balance of Initiation Fee Dollars, and proportionate Semi-Annual Dues up to next April 1st October 1st [strike out date not needed] must both be paid at time of initiation. Date_ _19_ Signature of Applicant (in his own handwriting)