INTO ORDER OF THE ARROW
To be reinstated into the Order of the Arrow, NISCHA CHUPPECAT Lodge, please fillout this form. The fee is $10.00 (for the current years dues) with proof of prior membership in the Order of the Arrow.
NAME_________________________________________________________________
ADDRESS______________________________________________________________
CITY________________________________________ STATE____________________
ZIP______________ PHONE_(_____)_______________________________________
District________________________________Unit & #________________________
DATE OF BIRTH___________________________
Inducted into the Order of the Arrow
Year & Lodge:______________________AGE OF ENTRY______________
Are you a ?
ORDEAL_____________BROTHERHOOD____________VIGIL______________
Please mail to: Hoosier Trails Council
Order of the Arrow
5625 E State Road 46
Bloomington, IN 47401