Merit/Service Checklist

Merit Bars Earned

Please check off all merit bars earned

Header Ritual Petitions Service Loyalty Friendliness Leadership Benevolence Pot of Gold Wreath Attendance RACOM Visitations 7 Initiations Camp Chevron

Number of Years of Perfect Attendance? * Notes (if any)

Offices Held

Please check off all offices held

WA WAA Charity Hope Faith Recorder Treasurer Chaplain Drill Leader Love Religion Nature Immortality Fidelity Patriotism Service Confidential Observer Outer Observer Musician Choir Director Choir Flag Bearer Page Big Sister

If she held the office for more than 1 term, please list station and number below: Notes (if any)

Installing Suite

Please check off all that apply

Installing Officer Installing Chaplain Installing Marshal Installing Recorder Installing Musician Installing Soloist

Please list how many times she has held each installing office. Notes (if any)

Grand Assembly

Please list each Grand Office held and Grand Year Please list each Grand Representative held, State and Grand Year Please list each Grand Installing Suite held and Grand Year Please list each Grand Cross Ceremony held for Grand Assembly and include Year Please list each Grand Grand Cross Ceremony for Nov 15 Banquets held and Grand Year If in Grand Choir, what years? If ever Miss Service, what year? Please list any other Awards received and years associated with each. Notes (if any)

Ritual Competition

Please check off all that apply

Supreme Ritualist Grand Ritualist Worthy Ritualist Floor Ritualist Bow Ritualist

Please list all years associated with each ritualist category.

Assembly Level

Please list projects you participated in your Assembly. Please list projects your organized in your Assembly. Please list projects you participated in Grand Assembly. Have you provided any Service to Rainbow Camp?

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All information submitted is accurate, true and can be verified by my Assembly. *

True False