Chanhassen, MN		 Reaffirming Fellowship Through Membership



Charitable Review Request Form

Please complete the form below as completely as possible as more information makes it easier to approve your request.If you would rather mail your request please include the same information and mail to:

Lions Club of Chanhassen
PO Box 484
Chanhassen, MN 55317

For whom and/or what organization is the donation requested?

What is the amount of your request?

How is the donation to be used?

Is this request sponsored by a Lion?

Name and Club of sponsoring Lion.

Have the Lions donated to this person or organization in the past?

If yes, when and what for?

Requestors Name:

Address:

Day Phone:

Evening Phone:

Email Address:

Date Submitted:

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