MARSEILLES LIONS CLUB CHRISTMAS BASKET SIGN UP FORM (L) LANTERNATIONAL The Marseilles Lions Club will provide Christmas baskets to local individuals and families who are in need. Each basket will include all the trimmings for a Christmas dinner and additional food products. Families with children will also receive toys (up to age 18). All persons requesting a Christmas Basket must have a Marseilles address. All names will be screened for proof of residency and need. Deadline for submitting names is Monday, December 11, 2023. Baskets will be delivered or picked up on Thursday, Dec. 21, 2023 at the Lions Hall between 9:00 a.m. and Noon PLEASE PRINT CLEARLY Family Name:. Address: (Street number or rural address - No P.O. Box Numbers) Total in family. Adults Phone number: Email address: Children: I Age i Age Age Children Male or Female Male or Female Male or Female Pick up basket [ ] Have basket delivered Age Age Age Male or Female Male or Female Male or Female This form may be mailed, dropped off or emailed to the Marseilles Lions Club, 511 Commercial St., Marseilles, IL 61341. Email: pdgbird1@mtco.com Club Phone: 815-795-2487 MARSEILLES LIONS CLUB CHRISTMAS BASKET SIGN UP FORM ( L ) LANTERNATIONAL The Marseilles Lions Club will provide Christmas baskets to local individuals and families who are in need . Each basket will include all the trimmings for a Christmas dinner and additional food products . Families with children will also receive toys ( up to age 18 ) . All persons requesting a Christmas Basket must have a Marseilles address . All names will be screened for proof of residency and need . Deadline for submitting names is Monday , December 11 , 2023 . Baskets will be delivered or picked up on Thursday , Dec. 21 , 2023 at the Lions Hall between 9:00 a.m. and Noon PLEASE PRINT CLEARLY Family Name :. Address : ( Street number or rural address - No P.O. Box Numbers ) Total in family . Adults Phone number : Email address : Children : I Age i Age Age Children Male or Female Male or Female Male or Female Pick up basket [ ] Have basket delivered Age Age Age Male or Female Male or Female Male or Female This form may be mailed , dropped off or emailed to the Marseilles Lions Club , 511 Commercial St. , Marseilles , IL 61341 . Email : pdgbird1@mtco.com Club Phone : 815-795-2487