Please complete this form to send a dispensation request to the Provincial office in Leyland. Your name (required)* First Last Your email (required)* Name of your lodge/chapter/group (required)*Your lodge / chapter number (required)*Please click the relevant radio button (required)*I am applying on behalf ofLodgeChapterGroupWhat are you applying to do? (required)*I am applying for a dispensation to do the following:Your role/office (required)*Please click the relevant radio buttonI am the lodge secretary/chapter scribe EzraI am NOT the lodge secretary/chapter scribe EzraReason for the dispensation request (required)*The reason(s) for the application is as follows:Date of meeting*What is the date of the meeting you require the dispensation for?I have notified the group chairman of this dispensation application* Yes Please enter the address you want the dispensation to be posted to:Address (required)* Street Address City County / State / Region ZIP / Postal Code CAPTCHA Toolbox PROVINCIAL OFFICE HOME SECRETARIES AND SCRIBES CEREMONIAL ADVICE NEW / JOINING MEMBERS FINANCE PROVINCIAL MEETING MINUTES MEMBERSHIP CHANGE FORM DISPENSATION REQUEST FORM CONTACT US FORM Tony Harrison.