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Deschutes Grange, Yelm Washington
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Application For Deschutes Grange Membership


Name_______________________________________________________________

Address_____________________________________________________________

City ________________________________________________________________

State________________________________________________________________

Zip_________________________________________________________________

Birthdate_____________________________________________________________

Phone_______________________________________________________________

E-mail_______________________________________________________________

I hereby apply for a non-voting membership in the grange organization at $41.00 a year +$10.00 application fee.

I hereby apply for regular membership in Deschutes grange #222 at $38.00 annually per adult plus $10.00 one-time application fee. I am 14 years of age or more and understand that my membership is subject to the bylaws of my subordinate Grange and to the constitution and bylaws of the State and National Granges. I understand that $3.02 of my annual dues pays for a subscription to the Washington State Grange News.

Amount enclosed___________________________

Make checks payable to: Deschutes Grange #222

Return to:  Deschutes Grange #222
                 PO box 768
                 Rainier, WA 98576
Maple Park Digital