This registration form is for Youth Officers, Ambassadors, Youth Couple, Legislative Experience
for anyone who wishes to participate in Youth activities and/or stay in
Youth housing at the 2013 National Grange Convention in Manchester, New Hampshire.

Use this registration form to choose your hotel options, provide your transportation
information and order tickets for meals and events.

At the end of the form, should you owe money, you will have to option to pay online using a credit card
or receive instructions on mailing a check to the National Grange office.
Questions? Contact Convention Planner Jessie Cope
by phone at 1-888-4-GRANGE x113 or via email at:
* Check one option that applies to you:

* I am:

Provide your transportation information and
Choose your Housing Preferences and

your Event and Meal Functions on the following pages
* Indicates Response Required
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The National Grange

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Washington, DC 20006