Please complete the form below as completely as possible as more information makes it easier to approve your request.

If you would rather mail your request you may download a form here.

Charitable Request Form

 

Be sure to press "Submit" at the bottom of this form when you are finished.

 

Is this donation for an individual or an organization?

 

Individual Organization

 

If the donation is going to an organization are you registered as a 501c3 ? (Documentation may be required.)

 

Yes No      

 

For whom and/or what organization is the donation requested?

 

 

 

What is the amount of your request?

 

 

How is the donation to be used?

Please include detailed information including a demonstration of need, who will benefit from this gift, other fundraising that is being done to meet this need, etc.

 

 

 

Is this request sponsored by a Lion?   

 

 

Name and Club of sponsoring Lion.

 

 

Have the Lions donated to this person or organization in the past?  

If yes, when and what for?

Requestors Name:

                 Address:

  Day Phone #

Evening Phone #

     E-Mail Address:

Date Submitted:

To complete this form, please click "submit" below. If you do not see our "Thank You" page the message did not go through. If you get an error message, please correct your request and press "Submit" again.

Thank You!

All requests are considered at our monthly business meeting held the third Tuesday of each month. You will be notified shortly thereafter of our decision.