Illinois State Grange Community Service Report Form 2011-2012

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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