Form 101-PH

APPLICATION FOR CITIZENSHIP
In the
AMERICAN KRUSADERS

(INCORPORATED)

Petition No._________

Line No._________

I, the undersigned, a foreign born, true and loyal resident of the United States of America, being a white, male Protestant Gentile person of temperate habits, sound in mind and a believer in the tenets of the Christian religion, the maintenance of White Supremacy and the principles of a PURE AMERICANISM, do most respectfully apply for membership in the American Krusaders through Kamp No._________, Realm of_________

I guarantee on my honor to conform strictly to all rules and requirements regulating my "naturalization" and the continuance of my membership, and to render at all times a strict and loyal obedience to your constitutional authority and the constitution and laws of the Order, not in conflict with the constitution and constitutional laws of the United States of America and the states thereof. If I prove untrue as a Krusader I will willingly accept as my portion whatever penalty your authority may impose.

The required "donation" accompanies this application.

Signed_________ Applicant

Endorsed by

Residence Address_________

KO_________

Business Address_________

KO_________

Date_________, 192_________

The person securing this application must sign on top line above. NOTICE—Check the address to which mail may be sent.

NOTICE

The sum of this donation MUST accompany application, if possible. Upon payment of same by applicant this certificate is made out and signed by person securing application, then detached and given to applicant, who will keep same and bring it with him when he is called, and then turn it in on demand in lieu of the cash.

DO NOT detach if donation is not paid in advance.

OFFICIAL
CERTIFICATE OF DONATION

This Certifies that_________

has donated the sum of TEN DOLLARS to the propagating fund of the

AMERICAN KRUSADERS

and same is accepted as such and as full sum of donation entitling him to be received, on the acceptance of his application, under the laws, regulations and requirements of the Order, duly naturalized and to have and to hold all the rights, titles, honors and protection as a citizen. He enters through the portal of

Date_________, 192_________

Received in trust for the

AMERICAN KRUSADERS, (INC.)

By KO_________