REQUEST FOR CHARITABLE FUNDS
Annandale Lions Club

Information and Requirements

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Due to automated hacking attempts against online forms like this one, our data fields require certain information and disallow certain characters.  See the notes by each field for compliance...

Date Requested

  (mm/dd/yy)

Name of organization or individual requesting funds

 
Alphanumeric, minimum 5 characters maximum of 20 characters.  No punctuation characters.

Funds to be used for?


Alphanumeric, minimum 10 characters maximum of 75 characters.  Periods and commas allowed.

If you have you requested donations from other sources for the same purpose, please list those organizations here.


Alphanumeric, minimum 10 characters maximum of 75 characters.  Commas allowed.

Amount Requested:

 
Numeric:  Periods/commas allowed.

Contact Name

 
Alphanumeric, minimum 5 characters maximum of 20 characters.  No punctuation characters.

Address

 
Alphanumeric, minimum 5 characters maximum of 50 characters.  No punctuation characters.

City, State, Zip

 
Alphanumeric, minimum 5 characters maximum of 25 characters.  No punctuation characters.

Email

 
Alphanumeric, minimum 5 characters maximum of 30 characters.  @ and . allowed.

Phone Number

(e.g. 3202746100)
Alphanumeric, minimum 7 characters maximum of 14 characters.  No punctuation characters.

Print, complete and mail to: 
-or-

(Click one time only)
Annandale Lion's Club
PO Box 285
Annandale, MN 55302