Chisago Lakes Lions

Request for Funds Application Form

Mission Statement:   The Chisago Lakes Lions Club's Primary Mission is to combine the talents of our membership to serve and raise funds for the needs of the sight and hearing impaired individuals in our Community,State and Country and throughout the World.

Our secondary focus is to direct efforts to the Chisago Lakes Community to help and serve individuals with basic needs, including but not limited to health, food and safety.

Policy Purpose:   The purpose of this policy is to provide criteria for awarding monetary donations that best fit our mission statement and also serve those in most need in the Chisago Lakes community. Annually the Chisago Lakes Lions Club will project revenues through planned fundraising, and budget for past projects and set aside funds for requests.

Please assist the Chisago Lakes Lions Club by answering the following questions and mail the completed form to: Chisago Lakes Lions Club, PO Box 71, Lindstrom MN, 55045. Requests are reviewed at a board meeting,  a  recommendation is made to the general membership and finally voted on. Determination is based upon the criteria below as well as the current financial position of the Club. If you have questions feel free to call Linda Lindgren at 651-257-6878 

  1. Is the request for sight or hearing impairment ?  Yes____  No ____

  2. Is this request for basic human needs or for services needed by a

       handcapped, disabled or disadvantaged individual ? Yes___  No____

  3. Does this request benefit individual(s) in the Chisago Lakes

      Community?  Yes____  No____

  4. Is this a program that is organized and/or recommened for support by

      Lions International?  Yes____  No____

  5. Is this a community project that provides services to the general public

      and promotes the Lions Name and Image? Yes____  No____

  6. If this request does not involve sight or hearing impairment or basic

      human needs, is this request the only means for funding this need?

      Yes____  No____

  7. Is this request for a fellow Lion or a need of another Lions Club in our

      Zone, District or State?  Yes____  No____

  8. Would you or someone supporting your cause be available to attend a

      Lions meeting if necessary to clarify and/or answer questions?

     Yes____  No____

Name:___________________ Amount of request:$______________

Address:_________________ City____________ State____ Zip______

Home Phone______________ Cell Phone_________________



Office use only___Approved___ Disapproved____

Amount of donation:$____________________  Date:____________





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