Hunger Relief Grant LCF-III

Company

This field is for validation purposes and should be left unchanged.

Date of Application(Required)

Project Description

Please describe your Hunger Relief Project or involvement with this food pantry.

Are you applying this grant to multiple Food Pantries?(Required)

Yes

Each club in LCFSV24i requesting a grant is authorized UP TO $1,000 for this program which can be split between no more than two Food Pantry Organizations supported by your club. The total amount cannot exceed $1,000.

If available, upload a PDF supporting document.

Accepted file types: pdf, Max. file size: 30 MB.

Only one PDF document under 100MB can be uploaded.

Food Pantry Name(Required)

Non-Profit (501c3) Tax ID

Food Pantry Amount(Required)

Food Pantry Address

Street Address City State ZIP Code

Hunger Relief Project Description(Required)

Food Pantry 2 Name(Required)

Non-Profit (501c3) Tax ID

Food Pantry 2 Amount

Food Pantry 2 Address

Street Address City State ZIP Code

Hunger Relief Project 2 Description(Required)

Project TOTAL(Required)

*Please correct Project 1 & Project 2 amounts, the GRAND PROJECT TOTAL cannot exceed $1000.00

Grand Project Total

Lions Club Information & Acknowledgement

Do you want the Hunger Relief Grant check mailed to the Lions Club or Food Pantry?(Required)

Lions Club Requesting Hunger Relief Grant

Mailing Address(Required)

Street Address City State ZIP Code

Club Representative(Required)

First Last

Club Representative Email Address(Required)

Club Representative Position(Required)

President

Secretary

Other

Club Representative Phone(Required)

Club Representative Signature

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