Lions Foundation of Canada Fellowship  
 
   
The Lions Foundation of Canada
Fellowship Award Order Form
Name of Honouree:
Name of Club:
Club Member :
Date of Presentation:
Contact Name:
Mail Address:
Town/City:
Province:
Postal Code:
Telephone: (Home) area code
(Work) area code
Fax Number: area code
E-mail Address:
   

 
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