Sun Prairie Lions Club

Charitable Review Request Form

 

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

 

Chris Mertes

PO Box 242.

Sun Prairie, WI 53590

608-837-2521

 

 

1.  How is the donation to be used? (Please include detailed information including a demonstration of need, who/what will benefit from this gift, other fundraising that is being done to meet this need, etc.) _____________________________________________________________________________________

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2.  For whom and/or what organization is the donation requested?  _______________________________ _____________________________________________________________________________________

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3.  What is the amount of your request?  ________________________________________

4.  Is this request sponsored by a Lion?   Yes ______  No ______     If Yes, Name and Club of sponsoring Lion:  _______________________________________________________________

 

5.  Have the Lions donated to this person or organization in the past?   Yes ______  No  _______

 

6.  If yes, when and what for?  ___________________________________________________________

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Requestors Name:  ______________________________________________________

Street  Address  _________________________________________________________

City:  ______________________________   State :  ____________  Zip:  ___________

Day Phone:  ___________________________

Evening Phone:    _______________________

Email Address:    _______________________

Date Submitted:   _______________________

Requests will be acted upon as soon as possible, but we appreciate four to six weeks for consideration.