Friends of the Grange, Inc.
MEMBERSHIP APPLICATION FORM



Standard Membership Privileges: Quarterly newsletters, advance notice of all Grange events and free guided tour privileges from April to October during regular tour hours.

Standard Membership
Individual—$15.00      Family—$30.00*
*Includes all members of the household

Enhanced Membership
These memberships entitle the member to tickets to the Annual Holiday Party to be among the first to see the Grange Mansion decorated for Christmas.

Contributor
$50.00
(1 ticket)
Supporter
$75.00
(2 tickets)
Sustainer
$100.00
(4 tickets)
Benefactor
$500.00
(10 tickets)

Memorials
Gifts in memory of friends and loved ones are welcomed by the Grange.  Please make checks payable to Friends of the Grange, Inc. and include your name, address and telephone number so that we may acknowledge your gift.  All donations are tax deductible to the full extent of the law.

Name:   

Address:   

City:   

State:   

Zip:   

CATEGORY:   

AMOUNT: $

Extra tax deductible donation
for Amphitheater development: $ ______________________

Please make check payable to: FRIENDS OF THE GRANGE, INC.

Mail to: FRIENDS OF THE GRANGE, INC.
143 Myrtle Avenue
Havertown, PA 19083