Vermont State Grange

Application For Subordinate Grange Membership

 Name:                    

 Address:             

 City or town:             State: Zip:    

 Occupation:       

 Email Address:    Phone Num:  

 County:                  Date of Birth: 

 I hereby apply for membership in the following Vermont Subordinate Grange   # . I desire to unite with others in elevating and advancing the interest of Agriculture and Rural Life, receiving in turn the benefits and advantages of those who belong to the Grange. I promise a faithful compliance with the By-laws of this Grange and the Constitution and By-laws of the State and National Granges. I have not previously applied for membership in this or any other Grange during the past six months.

 Signed:_____________________________________________  Date: ___________________

(Form can be signed at time of joining).