LIONS CAMP DORSET CORPORATION

HONOURARY LIFE DIRECTORSHIP APPLICATION

In 1984 the Board of Directors initiated the Honourary Life Directorship Program as a means of providing an ongoing source of funds for Camp Dorset. A constant cash flow is needed for general funding to enable the Camp to provide the highest possible service and facilities to its patients. Any individual member of a Lion, Lioness, Leo Club or any other person or group can become an Honourary Life Director of Camp Dorset Corporation by contributing the sum of $100.00 to Lions Camp Dorset Corporation. Lions/Lioness Clubs that achieve and maintain a 100% participation in the Directorship Program will receive a certificate and plaque acknowledging this status.

Date

Name

(Print Full Name to Appear on Certificate)

Address: Phone:

Fax:

E-Mail:

Affiliation: Lions Club_________________________________ District_________

Lioness Club_______________________________

Leo Club__________________________________

Other_____________________________________

Mailing address if other than recipient:

Address: Phone:

Fax:

E-Mail:

Application and payment should be given to the Chairlion of the Lion, Lioness or Leo Club in your District or mailed directly to:

Lions Camp Dorset Corporation, P.O. Box 306, Dorset, Ontario, P0A 1E0, Attention: Herb Taylor.

Email: lcdht@vianet.on.ca

www.lionscampdorset.on.ca