Illustrious  Order  of  the  Red  Cross

 

Requirements for Certification

 

(Revised 2002)

     Requirements

Date Completed

Examiner

Obligation or Vow

 

 

Jewish Pass

 

 

Persian Countersign

 

 

Red Cross Word

 

 

Sign of a Companion of the IORC

 

 

Grip of A Companion of the IORC

 

 

Word of a Companion of the IORC

 

 

 

Print Full Name

Of Examinee:    _________________________    _________________    ______________________

 

Print Name as Desired to Appear on Certificate: ___________________   __________  ______________

 

Certified Instructors Address for mail:

 

 ___________________________________   ____________________      N.C.   __________________

                          (Street)                                                                             (City)                                                               (ZIP)

 

Home Phone:  ________________________________________  Email address:  ___________________

 

Commandery Name:  _____________________________________  Number: ______________

 

Date Requirements mailed to Chairman:  __________________________

 

Mail to: Gerald W. Ringler

                                    Chairman, Ritual and Tactics

                                    121 Greencrest Circle

                                    Jacksonville, NC  28540-3014