The document is a request for a Letter of Good Standing from the Scottish Rite Valley. It contains the name, member number, current residence, and contact information of the requester. It also lists the Valley and Orient they are currently a member of. The requester signs and dates the document to formally ask for the letter to affiliate with the Kansas City Valley of the Scottish Rite.

1. REQUEST for LETTER of GOOD STANDING
Brethren;
I, (Name) ____________________________________________________ (Member No)._____________________
do hereby request that a Letter of Good Standing be issued to me for the purpose of Affiliating with the Kansas
City Valley of the Scottish Rite, Orient of Missouri of the Southern Jurisdiction of the United States.
My current residence is:
Residence _____________________________________________________________________________ Phone (____) ____-______
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Member of Valley:_____________________________________ (City) Orient: _____________________________ (State)
Signed ________________________________________________ Date _____/_____/________
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Ph. (816) 561-2277 FAX (816) 561-1615
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