Home
Meetings
About Us
Contact Lions
Banquet Room Rental
Members Only Section
Register
Toronto Beaches Lions Club
SERVING OUR COMMUNITY SINCE 1935 !!
Donor Form
Individual Completing Form
Applicant name:
Date:
Email:
Phone:
Purpose of Donation
Purpose of donation:
---------
Area of Greatest Need
Measles
Disaster
Humanitarian Needs
Sight
Youth
Other
Donor Details
Donor Name (Individual, Club, Company, Foundation):
Donor id:
Donor club:
Donor district:
Contribution Details
Amount of contribution:
Type of contribution:
---------
Full Payment
Installment
Final Installment
Gift Type
Gift type:
---------
US or Canadian Check Mailed Separately
Credit Card
Wire/Bank Transfer (Please Attach Receipt)
Local LCI Deposit (Please Attach Deposit Ticket)
Credit card type:
---------
Visa
Mastercard
American Express
Credit card number:
Credit card expiration date:
Credit card security code:
Name on credit card:
Signature
I authorize The Lions Club of Toronto Beaches to charge me for this donation.
I agree to the above
Use Funds Previously Donated
Please note - This section should only be filled out if sufficient funds have already been credit with the Lions Club International Foundation.
Use credits from:
Credits club id:
Recipient of Recognition
Recognition requested:
---------
MJF
PMJF
To Be Named Later
Memorial Plaque in memory of deceased
Recepient name:
Recepient member id:
Recepient address:
Recepient city:
Recepient state:
Recepient country:
Recepient postal code:
Recepient club:
Recepient club id:
Recepient club district:
Memorial
Please fill out a name for the memorial.
Memorial name:
Shipping Information
Ship to member id:
Ship to name:
Ship to address:
Ship to city:
Ship to province:
Ship to country:
Ship to postal code:
Ship to email:
Ship to phone:
Special Requests
Special instructions:
