Pompeo Coppini Lodge # 2712      

San Antonio, Texas    

 

 

 

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Membership Application

If you wish to become a member of the Pompeo Coppini lodge please complete complete this application form and either send it to us by email (by pressing "Submit" below) or print it and send it to us by fax or mail to the attention of our Recording Secretary. Once your application is received the lodge will contact you with respect to paying the appropriate membership and/or application fee.

Privacy Statement: We will never disclose this information to any third party.

First Name

Last Name

   

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My Occupation is

 

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Date of Birth                     Age   
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Being desirous to contribute to the moral concept that gathers and unites in a bond of brotherhood all persons of Italian origin, descent and/or their spouses in United States, I request to be admitted as a member of the Sons of Italy of America.

in the
Lodge Number
in the City of

To that purpose I swear on my honor and on my conscience that I promise to conform to and obey the By-laws of the said Order and Lodge and to submit to the decisions of its proper authorities as they are now and as they may be amended in the future.

Dated     At:

         

          


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