The National Grange of the Order of Patrons of Husbandry

Annual Convention Registration

Please send registration forms to National Grange by October 24, 2004

ROCHESTER NEW YORK
NOV. 9 - 13 , 2004

Personal Information (Please Print Clearly)
Name: ______________________________________________________________________________
Additional Names: ____________________________________________________________________
Grange: _____________________________________ State Grange: ___________________________
City: ________________________________________ State: ___________ Zip: __________________
Phone: _______________________________________
E-mail Address: ____________________________________________
Is this your first convention? Yes No

Functions and Events
Meal Tickets will not be mailed. They will be available for pick up at the Convention Office.
   
Date
Time
Function
Cost
Number
Total
N/A
N/A
Convention Registration
$10.00
_________
$ _________
N/A
N/A
Convention Pin
$5.00
_________
$ _________
11/09
12:15
p.m.Deli Buffet
$19.00
_________
$ _________
11/10
7:00
a.m.Salute to Agriculture Breakfast
$16.00
_________
$ _________
11/10
12:15
p.mGrange in Action Luncheon
$21.00
_________
$ _________
11/11
9:30
a.m.Rochester Tour
$25.00
_________
$ _________
11/11
11:00
a.m.Understanding PR Tour
Free
_________
$ _________
11/11
12:30
p.mPast Delegates Luncheon
$21.00
_________
$ _________
11/11
6:00
p.mYouth Pizza Party
$10.00
_________
$ _________
11/12
12:15
p.mGROW Club Luncheon
$21.00
_________
$ _________
11/13
12:00
p.mJunior Luncheon
$12.00
_________
$ _________
11/13
1:30
p.mJunior Tour Adult
$6.00
_________
$ _________
 Children (2-17)
$4.00
_________
$ _________
11/13
6:30
p.mGrange Celebration Banquet
$29.00
_________
$ _________
Total
$ _________
Total Enclosed
$ _________

*Please note: This is a registration form for convention activities only and is not a hotel registration form. Hotel reservations must be made separately.

***Please note: Convention Registration is $10 per person. You must register for Convention for admittance to An Evening of Excellence and Seventh Degree Conferral .

(MAKE CHECKS PAYABLE TO THE NATIONAL GRANGE)

 

 
NATIONAL GRANGE OF THE PATRONS OF HUSBANDRY
1616 H Street NW • Washington, DC 20006
(888) 4-GRANGE • (202) 628-3507 • Fax: (202) 347-1091
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