Shriners NextGEN
Shriners International Membership Department
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Country Code
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Area Code
Phone Number
City, State
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Age
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Job Title
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Company Name
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Temple
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Shrine ID
Please list your current Shrine Position
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Please indicate your leadership qualifications to support your consideration. (Please check all that apply.)
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Temple Potentate
Divan Officer
Club/Unit President
Club/Unit Officer
Please provide a history of your fraternal background and experience (including your Blue Lodge and other appendant bodies). Describe any leadership roles, projects, or events for which you have served. (150 words or less).
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0/150
Please provide a summation of any awards, accolades or recognitions you have received for fraternal service. (100 words or less.)
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0/100
Please select the three (3) areas below that you would note as your strongest skills.
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Membership Recruitment
Membership Awareness
Membership Retention
Membership Engagement
Social Media
Financial Planning
Leadership Experience
Brand Awareness/Development
Sales & Marketing
Strategic Planning
Human Relations
Event & Meeting Design
Millennials/Gen Z
Nonprofit Management
Describe techniques have you used to recruit new members. (150 words or less)
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0/150
Please describe any unique experiences or anecdotes to provide perspective from your fraternal leadership experience. (100 words or less)
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0/100
Please describe any new events, clubs, and/or units that you have created that successfully engaged young members. (150 words or less)
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0/150
Describe how serving as a leader in your Shrine contributed towards the success in your career. (150 words or less)
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0/150
Please tell us what you enjoy most about being a Shriner. (150 words or less)
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0/150
Are you a legacy member? (A legacy member is one who has continued the family tradition of fraternal membership.)
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Yes
No
If you answered yes above, please select your legacy member(s) from the list below. Hold the Ctrl Key to select more than one. (If you are not a legacy member, you can skip this question.)
Brother
Brother-In-Law
Step-Brother
Cousin
Father
Father-In-Law
Step-Father
Godfather
Grandfather
Grandson
Grand Nephew
Great Uncle
Great Grandfather
Great Grandson
Nephew
Son
Son-In-Law
Step-Son
Uncle
Other
Please upload a headshot photo of yourself. (Photo should be high quality of at least 1 megapixel and in .jpg or .png format)
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