John Trimble Legislative Experience

John Trimble Legislative Experience

Application Deadline: September 1st
Name

First NameLast Name
Age
Grange Name and Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date Joined Grange
Select top 3 committees you are interested in serving on: First Choice
Second Choice
Third Choice
What do you find most meaningful with the legislative aspect of the Grange?
Participation Waiver: By agreeing to participate in the John Trimble Legislative Experience I will be able to attend the National Grange Convention for the entire week and will be able to cover any costs associated with attending the convention. I understand that if I am unable to comply with rules set forth by the National Grange Youth Director and Legislative Director, I will be held liable to repay any expenses associated with my attendance. By signing below, I also give my permission to be photographed and appear in any publications produced by the National Grange.
Participant Signature (Or Parent/Guardian if under 18)

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Personal Biography

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One page document on why you want to participate in the JTLE and how you plan to use this experience in your future Grange story.

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Letter of Recommendation from State President OR State Youth Director

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Headshot Photo
Should be Empty: