Dear Brother,

In keeping with Masonic tradition of confidentiality, I am writing to ask your permission to publish any or all of the following information on our Lodge's web site. As you know, this information will be available to anyone with access to the World Wide Web. Initial in the appropriate column for each of the following:

 Approve Disapprove Correction
(Insert Full Name)   
(Insert Street Address)   
(Insert City)   
(Insert State)   
(Insert Zip Code)   
Lodge Office, Committee
Assignment, or Position
(Insert Other information)   
Portrait type photograph with
named caption
Group photos, video clips-
unidentified candid shots
Please provide any corrections necessary, sign and return


Your signature here____________________________________________

Thank you for your cooperation.

Sincerely and fraternally,

Signed by Worshipful Master or Webmaster