MOLLOY COLLEGE ATHLETICS :

MOLLOY COLLEGE ATHLETICS LIONS CLUB

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Lions Club Gift Designation Please designate my gift to (check circle):
The area of greatest need in Athletics	Contact Information
Baseball	_______________________________________ Name
Men's Basketball
Women's Basketball	_______________________________________ Address
Cross Country
Dance	_______________________________________ City/State/Zip
Equestrian
Men's Lacrosse	_______________________________________ Phone Number
Women's Lacrosse
Men's Soccer	_______________________________________ E-Mail
Women's Soccer
Softball	_______________________________________ Class Year(s)
Tennis
Volleyball
	Check Enclosed Visa Discover Mastercard
Level of Participation
Platinum Lion ($1000 or more)	Card Number
Gold Lion ($750-$999)
Silver Lion ($500-$749)	Expiration
Bronze Lion ($250-$499)
Junior Lion ($100-$249)	Amount to be Charges
** Many companies match their employee's gifts to their alma maters; please check with your human resources office.
** If you have an questions, please do not hesitate to call us at (516) 256-2207.	Signature

Please send your gift to the following address:

Molloy College
Department of Athletics
1000 Hempstead Avenue
Rockville Centre, NY 11571