2025 Community Service Report Form

2025 Community Service Report Form

This Report Form, when submitted, will go to National Community Service and is to be completed only by State Community Service Director or State President.
NAME OF STATE GRANGE PRESIDENT:
Name of State Grange President
President's Name

Street Address Line 2

State Grange President Phone numberState Grange President Email Address

Email Address
Please indicate if using a "Personal" or "State Grange" address for the President.

State Grange AddressPersonal Address
State Grange Address

Street Address

CityState

Zip codeCountry
Personal Address

Street Address

CityState

Zip codeCountry
NAME OF STATE GRANGE COMMUNITY SERVICE DIRECTOR:

State Grange Community Service Director

Street Address Line 2

State Community Service Director Phone numberState Community Service Director Email Address

Email Address
In order to receive monetary award and/or certificates from the National Grange, this report must be submitted to the Community Service Group. (30 days prior to certificate presentation is appreciated).
Total number of community service hours reported within your State:
Number of Project Sustenance hours (included in total number above):
Total number of Subordinate Granges in your State:
(Do not include Pomona – Junior – Youth. Send Junior & Youth reports to those respective Departments.)
Total number of Subordinate Grange community service reports received by your State:
Our State met the 25% threshold for $250.00 from National. Method of payment TBD and communicated.

YesNo
Please email CS Certificates* for printing and presentation to:

YesNo
Email
example@example.com
Our State did not meet the 25%; however, please email CS Certificates* for printing and presentation to:

YesNo
Email
example@example.com
The following Granges are to be issued CS Certificates:

State Grange Community Service Director

Street Address Line 2

Grange Name:Grange Number

Email Address
Type of Certificate:
Example: First Place, Honorable Mention, Outstanding Service, etc.
State Grange Community Service Director

Street Address Line 2

Grange Name:Grange Number

Email Address
Type of Certificate:
Example: First Place, Honorable Mention, Outstanding Service, etc.
State Grange Community Service Director

Street Address Line 2

Grange Name:Grange Number

Email Address
Type of Certificate:
Example: First Place, Honorable Mention, Outstanding Service, etc.
State Grange Community Service Director

Street Address Line 2

Grange Name:Grange Number

Email Address
Type of Certificate:
Example: First Place, Honorable Mention, Outstanding Service, etc.
EFFECTIVE 2025, THERE WILL NOT BE JUDGING OF
COMMUNITY SERVICE BOOKS ON THE NATIONAL LEVEL.
Books and electronic submissions of such
will not be taken or sent to the National level.
Competition at the State level is at each state’s option. The continuance
of books and electronic reports for historical use on local and state
levels is encouraged, in the format that works best for you.
Should be Empty: