Organization Donation Request
Organization Name
Organization Contact Name
Donation Request - First Name
Donation Request - Last Name
Organization Email
Organization Phone
-
-
Tax ID (501(c)(3)
Organization Website
Organization Facebook Page
Organizational Structure
501(c)(3) - General Fund
501(c)(3) - Specific Fund or Dedication
Not for Profit-non 501(c)(3)
Support Organization to a 501(c)(3)
Contact person's relationship to the Organization
Employee
Fund Raiser
Owner
Paid Worker
Volunteer
Other
Other
Lions Member Sponsor information
Organization Address
Street Address
Address Line 2
City
State
Zip Code
Lions Member Sponsor
*
Required
Alan Robbins
Alisha Mooney
Amber Dalakas
Andy Vidra
Annie Dean
Bob Williams
Claire List
Corbin Hockenbrock
David Long
Deborah Scolaro
Ed Nagy
Eric Neiger
Gary Harris
Greg Stanislawski
Jared Reid
Jay Bair
Jessica Koenig
Joan Armbruster
Joan Long
Joanne Dodaro
Leslie Burns
Makenna Synder
Margaret Hanich
Matt Sturgeon
Mike Ross
Mitch Doraty
Randy K'Meyer
Robin Slattery
Robin Sturgeon
Russ Martin
Sally Kral
Shelly Wharton
Sheri Back
Suzanne Rentschler
Tammy Starr-Feador
Ted Cavanaugh
Tim Cochrane
Tom DeVaux
Tom Melter
Tony Kirkby
Vanna Robbins
Vicki Perfect
Lions Sponsor Email
Lions Sponsor Phone
-
-
Organization Donation Request Information
Donation Amount
$2,000
$1,500
$1,000
$500
$250
Other
Other
Organization Mission/Purpose Statement
Please provide a short mission statement for your organization.
Organization Donation Request Description
Please describe the nature of your request: How are funds used? What is your charitable donation reach/impact?
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You can upload pertinent images (photos) to support your donation request.
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Email
website
Phone
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