Application to Join Schley Grange # 710

If you are interested in membership in a Schley Grange of Orange County, please fill out 
and return this form with payment to:

Mrs. Katherine Cheek
President, Schley Grange
715 Old Fayetteville Rd
Chapel Hill, NC 27516

Name: ___________________________________________________

Address: ________________________________________________

City: ___________________________________________________

State: NC

Zip Code: ________________

Phone (include area code): ______________________________

Email: _____________________________________

Occupation: ________________________________

Date of Birth: _____________________________

I hereby apply for Grange membership. I desire to unite with others in elevating
and advancing the interest of the American family and community life, receiving 
in turn the benefits and advantages of those who belong to the Grange.

Signature of applicant:	  ________________________________

Date:  ________________________________

Recommended by (please enter names of two current members):

	1. ________________________________________

	2. ________________________________________

Application fee is $15 per person per year.