
APPLICATION FOR ENROLMENT IN THE THIRD ORDER OF THE SOCIETY OF ST. PIUS
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Name:____________________________
Complete Baptismal Name:____________
Confirmation Name:_________________
Address:__________________________
City:________________________________
State:______ Post Code:______
Phone:_____________________________
Date of Birth: ________________ Sex: Male □ Female □
Status: Married □ Single □ Religious □
Are you a Catholic from birth: Yes □ No □
If not, in what year did you enter the Catholic Church?________
Have you ever belonged to another Third Order? Yes□ No □
Are you now a member of another Third Order? Yes □ No □
If so, which Order?__________________________________
Do you belong to a traditional Catholic Mass centre or parish? Yes □ No □
Name of church or parish:_____________________________
Address:__________________________________________
City:________________________________
State:______ Post Code:______
Priest:______________________ Coordinator:_________________________
□ I understand that I am to attend only the Latin Tridentine Mass and will not attend the Novus Ordo Mass.
□ I understand that there is a postulancy of one year before I make my commitment to the Third Order of the Society of St. Pius X. I will contact
the District Director when the year is nearly completed, asking to be accepted as a professed member.
□ I enclose a copy of my Baptismal Certificate or a statutory declaration from the Pastor of my Mass centre.
□ I have carefully read the Rule of the Third Order of the Society of St. Pius X and I understand it and
intend to be truly faithful to it.
Signature:________________________ Date:______________
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