International Order Of The Knights Of Saint Luke
Application Form for the Rank of
Knight Of The Order, Second Class (Officer)



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



2.Your Mail Address: ___________________________________________________


3. Date awarded Knight Of the Order, Third Class (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, Second Class (Officer): "I state that I seek to advance in The International Order of the Knights of Saint Luke 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 Saint Luke Evangelical Christian Ministries, the sponsoring ministry of this order."

________ I agree to the above. (order cannot be processed unless checked)

Copy and paste this form into an e-mail, fill it out appropriately, and e-mail it to Brother Dave. Use PayPal to send in your payment of $40.00.