1.  Full Name (as you wish it to appear on your membership credentials):

    _________________________________________________________________

2.  Your Mail Address: 

     ___________________________________________________

      ___________________________________________________

3.  Date awarded the title of Knight's Squire ____/____/____ (month/day/year)

4.  Check One: ______Male _____ Female

5.  You must agree to the following to be advanced by our order and receive the rank of Knight Of The Order, (Knight): "I state that I seek to advance in The Knights of the Holy Order of Deborah for honorable purposes and with a sincere heart. I agree to endeavor to follow the discipline of this rank, to practice courteous and charitable acts in my daily life even beyond what might ordinarily be expected, that I will always seek to do my best for the order, that I will endeavor to act to always reflect well on the order, and that I will respect and show true Christian love and compassion toward all peoples, and especially my fellow members of this order. I further state that I will also seek to always reflect positively on Shield Of Faith Christian Ministries, the sponsoring ministry of this order."

________ I agree to the above. (Recommendation and request cannot be processed unless checked)

Rev. Dr. Albert J. Martin

Grand Commander

Print and fill out this form and mail it along with a check or money order in the amount of $40.00 made out to:

Rev. Dr. Elizabeth Newman

Mail to: