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

_____________________________________________________________________

2.Your Mail Address: ___________________________________________________

___________________________________________________

3. Date of Ordination by Saint Luke Evangelical Christian Ministries ____/____/____ (month/day/year)

4. Check One: ______Male _____ Female

5. You must agree to the following to be accepted into our order and receive the rank of Knight Of The Order, Third Class (Squire) "I state that I seek to join 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, and to study God's Holy Word with an aim toward self-improvement and building my personal Christian Character, 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 the body of an e-mail, fill out appropriately and e-mail to Brother Dave at stlukeministries@gmail.com

Please make payment of $30 using PayPal.