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

Charitable Request Form

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

Charitable Donation Request
Is this donation for:
individual or 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? *
$
Dollars
.
Cents

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? *
 YES 
 NO 

Name and club of sponsoring Lion:

Have the Lions donated to this person or organization in the past? *
 YES 
 NO 
If yes, when and what for?

Requestors Name: *
Address: *
Email Address: *
Phone#: *
Date Submitted: *
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