Sallal Grange & Community Hall

Application for Subordinate Grange Membership – Sallal Grange #955

This may also be printed out and mailed to: Sallal Grange, PO Box 1688, North Bend, WA 98045

Name

Email

Mailing Address

City, State, Zip

Phone Number

Occupation

Are you 13 1/2 years of age or older?

Yes No

Recommended by

Date

I hereby apply for membership in the Sallal Grange #955 for the amount of $60.00* per year, receiving the benefits and advantages of those who belong to the Grange.

Signature of applicant

Submit

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*A small portion of membership dues pay for a subscription to the Washington State Grange News Distribution.