2025 National Grange Youth Ambassador Application

National Grange Youth & Young Adult Ambassador Application

Application Deadline: September 1st
Name

First NameLast Name
Role in which you are serving

Youth AmbassadorYoung Adult Ambassador
Age
Birthdate

MonthDayYear
Date
Gender

MaleFemale
Grange Name & Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date Joined Grange

MonthDayYear
Date
Are you interested in being a member of the National Grange Ambassador Team?

YesNo
Which contest(s) did you enter from the National Grange Youth Program Guide?
How has the Grange impacted you? (4-5 sentences)
Personal Bio (4-5 sentences)
Attach a 4x6 Headshot Photo
Letter of Recommendation from State President OR State Youth Director

Cancelof
Attach an Ambassador Resume (two page maximum) to include: Grange involvement with current and past leadership positions, awards, and events AND Non-Grange related community involvement and extracurricular activities with leadership positions, and awards.

Cancelof
Participation Waiver: By agreeing to participate in the Ambassador program, I will be able to attend the National Grange Convention Wednesday – Saturday 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 Team, 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 publication produced by the National Grange.
Participant Signature (Or Parent/Guardian if under 18)

Clear
Please verify that you are human*
Should be Empty:

National Grange Youth & Young Adult Ambassador Application