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Loclgc lrlame I the -rndersigned respectful y nominate Bro. Ciry. t. rr AJ lrrss Ciry antl State l. first Name candidate for the Daniel as a State residing ar l-/lst N4me Zipcdz Carter Bearr Masonic Scouter Award based on his service to Scouting as described on the attached page s. Fraternally Signature o/Nominator Bro. Prinr Name In Fdt LodgeName Lodge Number Zip Codt Steet Address II. M. of Pennsylvania and submitted with petition by the District Deputy to Cary Cohn who will then forward...
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The State of New York refers to the government entity and jurisdiction of the state of New York in the United States.
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