Illinois State Grange Community Service Report Form 2012-2013
Grange Name & Number: ______
City, County: ______
Chairperson(s) Name: ______
Address: ______
Signature: ______
Rules/Guidelines:
1. The deadline for the Community Service Report/Book is August 15, 2013. This means that the envelope containing the report/book must be postmarked no later than the above mentioned date. Please address the book/report to Sara Ellwanger, Community Service, 210 Gardner Street, Belvidere, IL 61008.
2. This form is to be included in the front of the report/book and to be used as a general summary of your Granges activities throughout the year.
3. Also included in the report/book is to be a completed form (or narrative) of the Community Service Action Plan for every activity that your Grange has participated in throughout the year.
4. Pictures, newspaper clippings, correspondence and any other publicity dealing with community activities may also be included.
~Volunteer Hours (total) ~
Grange Members enrolled in Grange: ______
Grangers that Participated in Community Service Activities: ______
Non-Member Participation in Community Service Activities: ______
Non-Member Hours: ______Grange Member Hours: ______
Total Community Service Hours for Year: ______
Brief Description of Grange and major Grange activities: ______
______
Did your Grange participate in the State Community service project by donating to the Rockford Area Pregnancy Care Center (please describe what and how)?______
Did your Grange submit a State nomination form for:
Non-Member Community Recognition Award: Yes No
Subordinate Grange Member Recognition : Yes No
Junior Grange Member Recognition Award: Yes No
Total number of community service projects your Grange participated in
from August 1, 2012 through July 31, 2013:______
Of those projects- Total number that were new: ______
Total Number that were continuing:______
Did your Grange participate in any fundraisers- either for their own Grange or for another organization? Yes No
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