REPORT FORM

Freemasons Victoria Integrity Unit

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* 1. Please provide your full name.

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* 2. Please provide your Lodge name and number.

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* 3. Please explain in detail any bad, poor, inappropriate and un-masonic conduct that you have witnessed or been subjected to.

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* 4. At what email address would you like to be contacted?

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* 5. What is your best contact number? If you do not wish to speak with anyone over the phone, please write 'blank'.