<p> Ohio State Grange Order Form Name______Send Orders to: Address______Ohio State Grange City______Zip______16303 Village Parkway Phone #______County______Fredericktown, OH 43019 Grange & No.______Description Quantity Price Amount Subordinate Manual – No: 454 $12.00 Subordinate Obligation Book – No: 448 $3.00 Alternative Manual – No: 456 $0.75 Pomona Manual – No: 455 $12.00 Pomona Obligation Booklet – No: 449 $3.00 Junior Manual – No: 453 $5.00 Junior Alternative Manual – No: 457 $0.75 Grange Initiate – No: 428 $0.75 The Grange and You – No: 509 $0.50 Dues-1st Notice, two-way mailer – No: 416 $0.15 Dues-2nd Notice, two-way mailer – No: 417 $0.15 Dues-3rd Notice – No: 418 $0.10 Suspension Notice – No 419 $0.10 Subordinate Demits – No: 411 $0.15 Dues Receipt, Annual Membership Card (25 cards in book) – No: 410 $2.00 Dues Receipts to Patrons (100 in book with stub) $1.00 Treasurer's Receipts, bound per 100 with stub $1.00 Treasurer's Receipt Book – No: 437 $3.00 Treasurer's Cash Book $5.00 Secretary Order to Treasurer – No: 435 $3.00 Secretary Record Book – No: 460 $25.00 Worksheets for Secretary Record Book – No: 463 $0.10 Secretary Roll Book – No: 464 $5.00 Grange 1” Binder with Grange Emblem (Blue) for Individual Member Records – No: 400 $5.00 Individual Member Record Sheet – No: 458 $.15 Junior Secretary Record Book – No: 459 $2.50 Junior Emblem – No: 326 $3.00 Seven Sided Grange Patch - Blue___Green___Maroon___ each No: 250 $2.00 Grange Emblem, 10" Decal – No: 303 $3.50 Decal Sheet (16 assorted) – No: 305 $2.50 Gold Foil Seals, 1 1/4" (100 on roll) No: 307 $10.00 Gold Foil Seals 1 1/4" individual $0.10 Car Decal (clear) No: 909 $1.00 Marble Paper Weight – No: 754 $7.00 The Grange Song Book – No: 603 $8.00 Pianist Grange Songbook – No: 604 $10.00 Junior Song Book – No: 602 $5.00 Applications: FREE FREE Subordinate____ Pomona____ Junior___ Shipping/Handling Charges: (on Subtotal only) Orde Orders:Up to $10.00 = $4.00 Orders: $10.01-$19.99 = $5.00 TOTAL-PAGE 1:______Orders: $20.00- $49.99 = $7.00 TOTAL-PAGE 2:______Orders: $50.00-$74.99 = $9.00 SUBTOTAL:______Orders: $75.00-$99.99 = 10.00 6 1/2 % TAX:______Orders: $100.00-124.00 = $12.00 Revised 01/06/2009 (subtotal X .065-round to nearest penny) S & H (rate to left):______(Over for Jewelry order) TOTAL AMOUNT DUE:______Ohio State Grange Jewelry Form Name______Send Orders to: Address______Ohio State Grange City______Zip______16303 Village Parkway Phone #______County______Fredericktown, OH 43019 Grange & No.______</p><p>Description Quantity Price Amount</p><p>4th Degree Button – No: 3 $5.00 4th Degree Pin – No: 11 $5.00 5th Degree Button – No:20 $5.00 5th Degree Pin – No: 24 $5.00 6th Degree Button – No: 30 $5.00 6th Degree Pin – No: 32 $5.00 7th Degree Button – No: 40 $5.00 7th Degree Pin – No: 43 $5.00 Junior Button – No: 1154 $5.00 Junior Pin – No: 70 $5.00 Grow Club Pin – No: 82 $6.00 Past Lecturer Pomona Pin – No: 1110 $15.00 Past Lecturer Subordinate Pin – No: 1104 $15.00 Past Master Pomona Pin with gavel –No: 1107 $15.00 Past Master Pomona Pin – No: 23 $5.00 Past Master Pomona Tie Tac – No: 25 $8.00 Past Master Subordinate Pin – No: 10 $5.00 Past Master Subordinate Pin with gavel – No: 1101 $15.00 Past Secretary Pomona Pin – No: 1109 $15.00 Past Secretary Subordinate Pin – No: 1104 $15.00 25 year (Silver Star) Button – No: 51 $7.00 25 year (Silver Star) Pin – No: 53 $7.00 40 year Button – No: 1119 $10.00 50 year (Golden Sheaf ) Button – No: 55 $20.00 50 year (Golden Sheaf) Pin – No: 57 $20.00 50 year OHIO Patron Button $7.50 50 year OHIO Patron Pin $7.50 55 year Button – No: 1121 $10.00 60 year Button – No: 58 $10.00 65 year Button – No: 1123 $10.00 70 year Button – No: 1124 $10.00 75 year Pin – No: 1125 $20.00 Mesh Back Hat (Navy) – No: 800 $5.00 Cotton Hat (Navy) – No: 801 $5.00 Grange Hat (Tan or Navy) – No: 802 $10.00 Men’s Belt Buckle – No: 938 $20.00 Grange Get Well Cards (10 per box) – No: 470 $3.00 Sympathy Cards (10 per box) – No: 471 $3.00 </p><p>TOTAL- PAGE 2:______(carry this amount to bottom of page 1) Revised 01/06/2009 </p>