Mother Advisor's Authorization Form

 

.
 

I am ,
the
(Check a box)
  Mother Advisor of
  Assistant Mother Advisor of
Assembly #,

By completing and sending this authorization, I authorize www.caiorg.org (the California Grand Assembly website) to include the following information on-line. Please check the items you are authorizing and enter the appropriate information.

  Home Phone:
  Home Address:
  E-mail Address:
  Alternate E-mail Address:
Enter comments in this box: 

Website use of items checked above is AUTHORIZED. Please check the box.
For validation, please enter the name of the seventh bow station in this box in lower case letters: 

 

   

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01/31/2008

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