| Name | Where do you reside? |
What is your occupation? | How old are you? | Do you hold membership
in, or are you sus- pended or expelled from any Lodge of this Order? |
Are you, so far as you know, in sound health? | Do you believe in the existence of a Supreme Intelligent Being, the Creator and Preserver of the Universe? |
Date |
| ABBOTT, Birt Lee | Shelbina, near | Farmer | 24 | No | Yes | Yes | 1 Mar 1915 |
| ADAMS, Frank | Shelbina | Laborer | 22 | No | Yes | Yes | 1 Sep 1913 |
| ADAMS, Leroy | Lentner | Farmer | 26 | No | Yes | Yes | 20 Jun 1960 |
| AYERS, Lee F. | Lakenan | Farmer | 24 | No | Yes | Yes | 13 Dec 1920 |
| BAILEY, Lewis | Shelbina | Mechanic | 42 | No | Yes | Yes | |
| BAILEY, Wood L. | Shelbina | Piano Tuner | 25 | No | Yes | Yes | 12 Nov 1923 |
| BARKELEW, Henry A. | Shelbina | Mortician | 51 | No | Yes | Yes | 3 May 1943 |
| BARTON, Edgar C. | Shelbina | Minister | 44 | No | Yes | Yes | 9 Jun 1924 |
| BATTSON, Frank M. | Shelbina | Rural Letter Carrier | 35 | No | Yes | Yes | 5 Nov 1923 |
| BEAN, Harry Thomas | Shelbina | Farmer | 24 | No | Yes | Yes | 13 Oct 1913 |
| BECKETT, Charles Wesley | Shelbina | Farmer | 25 | No | Yes | Yes | 22 Jan 1922 |
| BOWEN, Earl | Shelbina | Farmer | 33 | No | Yes | Yes | 20 Apr 1959 |
| BOWEN, Lloyd | Shelbina | Plumber | 31 | No | Yes | Yes | 20 Apr 1959 |
| BRANSCOMB, Ralph | Shelbina | Merchant | 30 | No | Yes | Yes | 2 Apr 1946 |
| BROCK, Fredrick | Hunnewell | Teacher | 28 | No | Yes | Yes | 24 Oct 1949 |
| BYARS, Leland W. | Shelbina | Merchant | 25 | No | Yes | Yes | 21 Feb 1921 |
| CAROTHERS, John A. | Shelbina | Clerk | 33 | No | Yes | Yes | 17 Jul 1944 |
| CARROLL, John L. | Shelbina | Filling Station | 29 | No | Yes | Yes | 4 Dec 1952 |
| CARROLL, Russell D. | Shelbina | Farmers Exchange General Work | 25 | No | Yes | Yes | 28 Oct 1937 |
| CLAUSE, C. W. | Shelbina | Flour Packer | 38 | No | Yes | Yes | 15 Jan 1912 |
| COLLINS, J. T. | Shelbina | Liveryman | 36 | No | Yes | Yes | 10 Mar 1913 |
| DALE, James | Shelbina | Track Work | 33 | No | Yes | Yes | 1 Sep 1913 |
| DAVIS, J. D. | Shelbina | ? | 19 | No | Yes | Yes | 6 Jul 1942 |
| DIXSON, James | Shelbina | Service Station | 29 | No | Yes | Yes | 21 Mar 1968 |
| DRY, Combs | Shelbina | Teamster | 27 | No | Yes | Yes | 1 Sep 1913 |
| FARISS, Kenneth | Shelbina | Grocery Man | 28 | No | Yes | Yes | 25 Jan 1938 |
| GARRISON, Robert | Shelbina | Telephone Lineman | 27 | No | Yes | Yes | 4 Dec 1952 |
| GIBSON, Ernest L. | Shelbyville | Farmer | No | Yes | Yes | 3 May 1943 | |
| GLOVER, Robert | Shelbyville | Carpenter | 19 | No | Yes | Yes | 24 Oct 1949 |
| GOSNEY, Rex | Shelbina | Farmer | 49 | No | Yes | Yes | 4 Dec 1952 |
| HAINLINE, W. O. | Shelbina | Farmer | 26 | No | Yes | Yes | 9 Feb 1914 |
| HALE, J. E. | Shelbina | Farmer | 29 | No | Yes | Yes | 1 Sep 1913 |
| HARRISON, Burdell | Shelbina, 5 miles north of | Teacher | 20 | No | Yes | Yes | 28 Mar 1926 |
| HARRISON, Lloyd | Shelbina | Blacksmith | 23 | No | Yes | Yes | 8 Nov 1920 |
| HARRISON, W. P. | Shelbina | Carpenter | 26 | No | Yes | Yes | 15 Dec 1913 |
| HAYES, Jack C. | Shelbina | Service Station Attendant | 44 | No | Yes | Yes | 2 Feb 1954 |
| HEATHMAN, William H. | Shelbina | Engineer Light Plant | 43 | No | Yes | Yes | 16 May 1960 |
| HOWARD, Ival | Shelbina | Tractor Operator | 29 | No | Yes | Yes | 25 Jan 1938 |
| HOWELL, Alva Arthur | Shelbina | Garage Mechanic | 24 | No | Yes | Yes | 26 Dec 1921 |
| HOWELL, Carl Shawn | Shelbina | Produce Worker | 30 | No | Yes | Yes | 1 May 1944 |
| HOWELL, Ernest | Salt River Township | Farmer | 22 | No | Yes | Yes | 20 Jan 1913 |
| HUTTON, Harry | Shelbina | Mechanic | 38 | No | Yes | Yes | 27 Jan 1953 |
| JONES, J. R. | Shelbina | Miller | 43 | No | Yes | Yes | 3 May 1943 |
| JONES, Lloyd | Shelbina | Mechanic | 47 | No | Yes | Yes | 2 Feb 1954 |
| JORDAN, C. P. | Shelbina | Farmer | 33 | No | Yes | Yes | 1 Sep 1913 |
| KEISTER, Alvin | Shelbina | Mechanic | 39 | No | Yes | Yes | 27 Jan 1953 |
| KENNEY, Bruce | Shelbyville | Merchant | 41 | No | Yes | Yes | 2 Oct 1949 |
| KIMBEL, Francis Wayman | Shelbina | Post Office Clerk | 33 | No | Yes | Yes | 1 May 1944 |
| KNOWLES, William A. | Annabel | Minister | 50 | No | Yes | Yes | 9 Nov 1964 |
| KROPF, Walter Harley | Shelbina | Farmer | 32 | No | Yes | Yes | 6 Aug 1945 |
| KUNCE, Frank L. | Shelbina | 24 | No | Yes | Yes | 4 Dec 1952 | |
| LARRICK, Clive | Shelbina | Farmer | 48 | No | Yes | Yes | 16 Mar 1964 |
| LEATON, J. W. | Shelbina | Telegraph Operator |
39 | No | Yes | Yes | 12 Feb 1912 |
| MAGRUDER, C. E. ("Jack") | Shelbina | Farmer | No | Yes | Yes | 27 Jan 1953 | |
| MAGRUDER, Marvin | Shelbina | Farmer | 40 | No | Yes | Yes | 4 Dec 1952 |
| MARTIN, Carl | Shelbina | Oil Man | 36 | No | Yes | Yes | 1 Sep 1913 |
| MAYES, Kenneth | Shelbina | Agency for Oil Company | 27 | No | Yes | Yes | 24 Mar 1953 |
| MCGEE, J. Lloyd | Shelbina | Baker | 23 | No | Yes | Yes | 30 Nov 1925 |
| MIDDLETON, W. G. | Monroe County | Farmer | 42 | No | Yes | Yes | 27 Dec 1915 |
| MILLER, Clifford | Shelbina | Baker | 32 | No | Yes | Yes | 20 May 1918 |
| MITCHELL, Billy | Shelbina | Steel Inspector | 39 | No | Yes | Yes | 16 Mar 1964 |
| MOON, Carry B. | Shelbina | Laborer | 29 | No | Yes | Yes | 1 Sep 1913 |
| MOON, Charles | Shelbina | Clerk | 23 | No | Yes | Yes | 31 Mar 1913 |
| MORRISON, Carl | Shelbina | Merchant | 21 | No | Yes | Yes | 12 Nov 1923 |
| OLBERT, Irvin | Shelbina | Tank Wagon Agent | 47 | No | Yes | Yes | 2 Feb 1954 |
| PARKER, Darrell | Shelbyville | Farmer | 23 | No | Yes | Yes | 7 Mar 1949 |
| PRITCHARD, T. D. | Shelbina | Farmer | 31 | No | Yes | Yes | 9 Feb 1914 |
| PRUDEN, Robert W. | Shelbina | Truck Driver | 26 | No | Yes | Yes | 5 Mar 1946 |
| PURDY,
Ernie |
Shelbina | Truck Driver | 23 | No | Yes | Yes | 25 Sep 1944 |
| PURDY, Lewis Vernon | Shelbina | Produce Worker | 36 | No | Yes | Yes | 1 May 1944 |
| RAMSEY, Harold | Shelbina | Service Station | 36 | No | Yes | Yes | 24 Mar 1953 |
| RASH, Gail | Shelbina | Laborer | 20 | No | Yes | Yes | 25 Jan 1938 |
| RASH, Walter | 40 | Yes | 4 Dec 1952 | ||||
| RASH, William F. | Shelbina | Truck Driver | 20 | No | Yes | Yes | 5 Mar 1946 |
| RATLIFF, Jerry | Shelbina | Farmer | 28 | No | Yes | Yes | 20 Apr 1959 |
| REYNOLDS, Morris Paul | Shelbina | Farmer | 24 | No | Yes | Yes | 20 Apr 1959 |
| SANDERS, Myron Haden | Shelbina | Farmer | 41 | No | Yes | Yes | 1 May 1944 |
| SAUER, John C. Sr. | Shelbina | City Marshall | 52 | No | Yes | Yes | 6 Mar 1961 |
| SCHWADA, Billy Don | Shelbyville | Laborer | 19 | No | Yes | Yes | 24 Oct 1949 |
| SCHWARZ, Antone | Lentner | Farmer | 33 | No | Yes | Yes | 20 May 1918 |
| SHOEMAKER, C. T. | Shelbina | Laborer | 26 | No | Yes | Yes | 10 Mar 1913 |
| SHRIDE, Kenneth | Emden | Farmer | 39 | No | Yes | Yes | 6 Mar 1961 |
| SNIDER, Delbert | Shelbina | Grocery Clerk | 55 | No | Yes | Yes | 6 Mar 1961 |
| SNIDER, John W. | Shelbina | Farmer | 30 | No | Yes | Yes | 26 Feb 1917 |
| SPARKS, Victor | Shelbina | Truck Driver | 18 | No | Yes | Yes | 25 Jan 1938 |
| STAUSS, Edward | Shelbina | Baker | 36 | Woodman | Yes | Yes | 1 Sep 1913 |
| STEVENS, Orville, Jr. | Shelbina | Clerk | 26 | No | Yes | Yes | 16 Nov 1954 |
| STUDER, Harry | Shelbina | Laborer | 40 | No | Yes | Yes | 25 Mar 1952 |
| TODD, Donald | Lentner | Farmer | 18 | No | Yes | Yes | 20 Jun 1960 |
| TODD, Keven B. | Lentner | Farmer | 18 | No | Yes | Yes | 10 Oct 1966 |
| TODD, Lloyd | Shelbina | Mechanic | 53 | No | Yes | Yes | |
| TODD, W. B. | Shelbina | Surveyor | 60 | No | Yes | Yes | 21 Dec 1925 |
| TODD, William D. | Shelbina | Street Commissioner | 30 | No | Yes | Yes | 16 May 1960 |
| TURNER, Joel Franklin | Shelbina | Limestone Contractor | 34 | No | Yes | Yes | 15 Jan 1945 |
| VICK, Albert | Shelbyville | Merchant | 43 | No | Yes | Yes | 24 Oct 1949 |
| WAITE, John William | Shelbyville | Merchant | 42 | No | Yes | Yes | 24 Oct 1949 |
| WAY, William U. | Shelbina | Farmer | 44 | No | Yes | Yes | 6 Dec 1915 |
| WEAR, Raymond | Shelbina | Truck Driver | 23 | No | Yes | Yes | 5 Mar 1946 |
| WEBBER, Henry | Lakenan | Post Master | 31 | No | Yes | Yes | 25 Sep 1922 |
| WESSBERG, B. S. | Shelbina | Teamster | 24 | No | Yes | Yes | 4 Sep 1913 |
| WHITE, Charles S. | Shelbina | Highway Dept. | 66 | No | Yes | Yes | 20 Apr 1959 |
| WHITE, Ray R. | Shelbina | Farmer | 22 | No | Yes | Yes | 21 Jan 1924 |
| WHITE, Thomas B. | Shelbina | Real Estate | 42 | No | Yes | Yes | 15 Jan 1912 |
| WHITE, William W. | Shelbina | Store Manager | 38 | No | Yes | Yes | |
| WILSON, Harold L. | Shelbina | Retail Dairy | 38 | No | Yes | Yes | 2 Feb 1954 |
| WILSON, Morris D., Jr. | Shelbyville | Teacher | 19 | No | Yes | Yes | 24 Oct 1949 |
| WILSON, Richard B. | Shelbyville | Garage Man | 32 | No | Yes | Yes | 7 Mar 1949 |
| WILSON, William Weaver | Shelbina | Truckman (?) | 32 | No | Yes | Yes | 1 May 1944 |
| WILT, Jack | Shelbina | Farmer | 22 | No | Yes | Yes | |
| WILT, Wayne | Shelbina | Farmer | 37 | No | Yes | Yes | 16 Mar 1964 |
| WOOD, J. M. | Shelbina | Farmer | 41 | No | Yes | Yes | 29 Sep 1958 |