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Download TEXAS LIONS MUSEUM AND OFFICE FOUNDATION, INC. TEXAS LIONS MUSEUM AND OFFICE FOUNDATION, INC. Application

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  • TEXAS LIONS MUSEUM

    AND

    OFFICE FOUNDATION, INC.

    Application for Everett J. Grindstaff Fellowship or Life Membership

    Please check one: Fellowship ($500)

    Life Membership ($100)

    Donor Information:

    Multiple District _________________ District _____________ Other __________________

    Club Name and City _____________________________________________________________

    Purchaser ______________________________________________________________________

    Recipient Name _________________________________________________________________

    (please print as it should appear on plaque and/or certificate)

    Mailing Address ________________________________________________________________

    (physical address)

    ______________________________________ ____________ __________

    (city) (state) (zip)

    Special Instructions: _____________________________________________________________

    ______________________________________________________________________________

    ------------------------------------------ Payment Information ------------------------------------

    Check No. ______ payable to Texas Lions Museum and Office Foundation, Inc.

    OR

    Credit Card No. __________________________ Expires__________ CVV ____

    Return to: MD2 Texas Lions State Office P.O. Box 294509 Kerrville, Texas 78029

    Multiple District: District: Other: Club Name and City: Purchaser: Recipient Name: Mailing Address: (city): (state): (zip): Special Instructions: Special Instructions_1: Check No: Credit Card No: Expires: CVV: Group1: Off

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