Application for Membership Subordinate Grange #499
Freshwater
Please Note: When you arrive for your first meeting (2nd Tuesday of month at 7pm) you will need to complete and sign a State Grange form and pay all fees.

To the officers and members: I, (name)
Mailing address
                        
                  City Zip
Phone Birthdate
E-mail Occupation (if retired, please list previous occupation) respectfully petition to be initiated and enrolled as a member of your Grange. In presenting this application, I am influenced by no motive other than a desire to unite with others in elevating and advancing the interest of Husbandry and Rural Life and receiving in return such benefits and advantages as may accrue to all who belong to the Grange. I promise a faithful compliance with the By-Laws of this Grange, and the Constitution and Laws of the State and National Grange. I have not previously applied for membership in this or any other Grange within the past 6 months.

Date: Recommended by: