North Carolina State Grange Junior Leadership Application

North Carolina State Grange

2025 Junior Leadership Application
Applications are DUE by FRIDAY, MAY 16, 2025
SECTION 1: Personal Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Birthday*

MonthDayYear
Age at Camp*
Phone Number - Home
Phone Number - Cell
E-mail - Personal (if you have one)
E-mail - Parents*
Grange Name
Number of years as a Junior Granger
Number of years you have attended Grange Camp*
Name of School*
Grade*
Tee Shirt Size*
Consent and Release of Photos *
Please attach a headshot/school photo.

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SECTION 2: Leadership Experience and Community Involvment:
Please list School, Grange, Church, and Community Activities in which you are involved:*
Please list Hobbies and Interests:*
List 5 words that best describe you:*
Tell me what you love about the Grange:*
Why would you like to serve on the Junior Leadership Team?*
SECTION 4: Commitment

One of the requirements to be chosen to serve on the Junior Leadership Team; you have to be able to attend camp (July 6-12). If you are chosen, will you be at camp to serve on the team?
Commitment*
Applicant Signature*

Clear
Parent Signature*

Clear
Should be Empty: