Ohio State Grange Order/Supplies Form
Name______Send Orders to:
Address______Ohio State Grange
City______Zip______16303 Village Parkway
Phone #______County______Fredericktown, OH 43019-9585
Grange & No.______
Description / Quantity / Price / AmountSubordinate Manual – No: 454 / $12.00
Subordinate Obligation Book – No: 448 / $3.00
Alternative Manual – No: 456 / $0.75
Pomona Manual – No: 455 / $12.00
Pomona Obligation Booklet – No: 449 / $3.00
Junior Manual – No: 453 / $5.00
Junior Alternative Manual – No: 457 / $0.75
Grange Initiate – No: 428 / $0.75
The Grange and You – No: 509 / $0.50
Dues-1st Notice, two-way mailer – No: 416 / $0.25
Dues-2nd Notice, two-way mailer – No: 417 / $0.20
Dues-3rd Notice – No: 418 / $0.15
Suspension Notice – No 419 / $0.10
Subordinate Demits – No: 411 / $0.15
Dues Receipt, Annual Membership Card
(25 cards in book) – No: 410 / $2.00
Dues Receipts to Patrons (100 in book with stub) / $1.00
Treasurer's Receipts, bound per 100 with stub / $1.00
Treasurer's Receipt Book – No: 437 / $3.00
Treasurer's Cash Book / $5.00
Secretary Order to Treasurer – No: 435 / $3.00
Secretary Record Book – No: 460 / $30.00
Worksheets for Secretary Record Book – No: 463 / $0.10
Grange Roll Book – No: 464 / $4.00
Grange 1” Binder with Grange Emblem (Blue) for Individual Member Records – No: 400 / $5.00
Individual Member Record Sheet – No: 458 / $.15
Junior Secretary Record Book – No: 459 / $2.50
Junior Emblem – No: 326 / $3.00
Seven Sided Grange Patch - Blue___Green___Maroon___
No: 250 / each $2.00
Grange Emblem, 10" Decal – No: 303 / $3.50
Decal Sheet (16 assorted) – No: 305 / $2.50
Gold Foil Seals, 1 1/4" (100 on roll) No: 307 / $10.00
Gold Foil Seals 1 1/4" individual / $0.10
Car Decal (clear) No: 909 / $1.00
Marble Paper Weight – No: 754 / $7.00
The Grange Song Book – No: 603 / $8.00
Pianist Grange Songbook – No: 604 / $10.00
Junior Song Book – No: 602 / $5.00
Applications: / FREE / FREE
Subordinate____ Pomona____ Junior___
Shipping/Handling Charges: (on Subtotal only)
Orde Orders: Up to $10.00 = $4.00
Orders: $10.01-$19.99 = $5.00 TOTAL-PAGE 1:______
Orders: $20.00- $49.99 = $7.00 TOTAL-PAGE 2:______
Orders: $50.00-$74.99 = $9.00 SUBTOTAL:______
Orders: $75.00-$99.99 = 10.00 6 1/2 % TAX:______
Orders: $100.00-124.00 = $12.00 Revised January 2013 (subtotal X .065-round to nearest penny)
Make checks payable to: Ohio State Grange S & H (rate to left):______
(Over for Jewelry order) TOTAL AMOUNT DUE:______
Page 2
4th Degree Button – No: 3 / $5.00
4th Degree Pin – No: 11 / $5.00
5th Degree Button – No:20 / $5.00
5th Degree Pin – No: 24 / $5.00
6th Degree Button – No: 30 / $5.00
6th Degree Pin – No: 32 / $5.00
7th Degree Button – No: 40 / $5.00
7th Degree Pin – No: 43 / $5.00
Junior Button – No: 1154 / $5.00
Junior Pin – No: 70 / $5.00
Grow Club Pin – No: 82 / $6.00
Past Lecturer Pomona Pin – No: 1110 / $15.00
Past Lecturer Subordinate Pin – No: 1105 / $15.00
Past Master Pomona Pin with gavel –No: 1107 / $15.00
Past Master Pomona Pin – No: 23 / $5.00
Past Master Pomona Tie Tac – No: 25 / $8.00
Past Master Subordinate Pin – No: 10 / $5.00
Past Master Subordinate Pin with gavel – No: 1101 / $15.00
Past Secretary Pomona Pin – No: 1109 / $15.00
Past Secretary Subordinate Pin – No: 1104 / $15.00
25 year (Silver Star) Button – No: 51 / $7.00
25 year (Silver Star) Pin – No: 53 / $7.00
40 year Button – No: 1119 / $10.00
50 year (Golden Sheaf ) Button – No: 55 / $20.00
50 year (Golden Sheaf) Pin – No: 57 / $20.00
50 year OHIO Patron Button / $7.50
50 year OHIO Patron Pin / $7.50
55 year Button – No: 1121 / $10.00
60 year Button – No: 58 / $10.00
65 year Button – No: 1123 / $10.00
70 year Button – No: 1124 / $10.00
75 year Pin – No: 1125 / $20.00
Badge Holders – No. 940 / $4.00
Grange Mug, 15oz, white & blue w/ Grange Emblem –No. 940 / $7.50
Mash Back Hat (Navy) – No. 800 / $5.00
Grange Twill Cap w/ Grange embroidered / $12.00
Cotton Hat (Navy) – No. 801 / $5.00
Grange Hat (Tan or Navy) – No. 802 / $10.00
Grange medallion – No 937 / $6.00
Men’s Belt Buckle – No 938 / $20.00
Grange Get Well Cards (10 per box) – No. 470 / $3.00
Sympathy Cards (10 per box) – No 471 / $3.00
Thank You Notes (10 per box) – No 472 / $3.00
25 year Silver Star Certificate with folder / $2.50 / No shipping
40 Year Seal / $2.50 / or handling
55 Year Seal / $2.50 / charges on
60 Year Seal / $2.50 / Certificates or
65 Year Seal / $2.50 / Seals. Must
70 Year Seal / $2.50 / add 6.5% tax
TOTAL- PAGE 2:______
(Carry this amount to bottom of page 1)
Revised January 2013