I hereby Authorize the following Sir Knight to act as my proxy at the Annual Conclave of the Grand Commandery of Knights Templar of the State of Wisconsin. (Enter the proxy name below) *
Your answer
The above Sir Knight is a member of the following Commandery (Name and Number) *
Your answer
My name is *
Your answer
My Commandery Title is *
Your answer
My Dues Card Number (from dues card) is *
Your answer
A copy of your responses will be emailed to the address you provided.