OTTERBEIN
LODGE NO. 561
F &
AM of INDIANA, USA
2004 MEMBERSHIP QUESTIONNAIRE
1 - What I would like to see our lodge fix about masonry
is____________________________________________
2 - My lodge does not
_________________________________________________________________________________
3 - I am happy with
___________________________________________________________________________________
4 - I am displeased with
______________________________________________________________________________
5 - I would show up more often if
____________________________________________________________________
6 - If the dues are raised again I will _____ / will not_____ pay them.
7 - I do _______ / do not _______want to spend some time on the phone
with my lodge's officers.
8 - Brother __________ left our lodge and I can______ / cannot_______
help him return to masonry.
9 - Brother __________ left our lodge and I would appreciate some help
bringing him back to masonry.
10 - I am available for funerals _________ and other lodge events
_______, please add me to the call list(s).
Name _____________________________________________
email ______________________________________________
phone _____________________________________________