Please accept my contribution of $________ to become a supporter of the programs of the Nebraska Lions Foundation, Inc. as indicated below.

The Builder Program
___ Builder ($50)
___ Senior Builder ($100)
___ Grand Builder ($250)
___ Master Builder ($500)
___ Dennis Hull Fellowship ($1,000)

The Sustaining Member Program
___ Sustaining Member ($25)
___ Life Member ($300)
___ Contributing Member ($2,500)
___ Pride Member ($5,000)
___ Monarch Member ($10,000)

Name:______________________ Address:_____________________
City, State, Zip:___________________________________
Phone:_______________________
Lions Club Affiliation:_____________________________

Please make your check payable to:
The Nebraska Lions Foundation
2006 S. 138th St.
Omaha, NE 68144

The Nebraska Lions Foundation, Inc., is a charitable not-for-profit corporation, 501.c.3, in the State of Nebraska