Request a Donation

Organization or Individual Requesting Donation

Contact Person if requesting for an organization

Phone

Address

City, State, Zip

If donation is approved, who should the check be payable to?

Lions contact person

Are you involved in Charitable Gambling?

Yes

If you are a 501c3, upload your determination letter and completed W-9 form here

501c3 Determination Letter Upload

If you are a government organization, such as a school, upload your LG555 form here

LG555 Form Upload

Amount you are Requesting

Please give a brief proposal or reason for your donation request.

For organizations or groups, what other means of fundraising have been done for this project?

Please list other organizations that have been contacted and any amounts received as donations for this event/project/cause.

Organization

Amount Requested AND Amount Received

Organization

Amount Requested AND Amount Received