I would like to pledge/contribute at the following level...

_____ Charter Member $1000 or more before 5/31/09

_____ Pioneer Member $500 or more before 5/31/09

_____ Sustaining Member to contribute $ ____ each year

_____ Supporting Member one time donation $20 or more

my contribution is $ _________

_____ Other

Name ____________________________

Address __________________________

City, State, Zip _____________________

phone ________________

email ____________________________

Thank you for your support

Make Checks Payable to:

Lions Camp Badger Foundation

725 LaRue Road

Spencer, NY 14883

PLEASE PRINT THIS PAGE - SEND WITH CONTRIBUTION