Molloy College


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MOLLOY COLLEGE ATHLETICS LIONS CLUB

To print a .pdf version of the above form, please click here.

 

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

 


Schedule Complete.