LIONS OF ILLINOIS FOUNDATION
2814 DE KALB AVENUE
SYCAMORE, IL 60178
Voice: (815) 756-5633 ext 222
FAX (815) 748-9087
E- mail: JDELBY@TBC.NET

An active worker, either on a busy corner or in a house-to-house campaign can give away at least ONE
CASE (350 suckers per box) of Tootsie Pops in a day. Order carefully, bases on the number of workers
you will have and the population of your area.

PLEASE COMPLETE AND RETURN THIS FORM AS SOON AS POSSIBLE.

_______________________CASES OF TOOTSIE POPS (350 SUCKERS PER CASE) NO COST
_______________________ CASES OF TOOTSIE POPS (1,050 SUCKERS PER CASE)
_______________________ CANDY APRONS @ $ 8.00 PER APRON
Post Office Number of Rural Routes Not Accepted
TOOTSIE POP ORDERS will not be accepted after April 25, 2008

FREE TOOTSIE POP DAY SUPPLIES
(Please enter quantity in space provided. Note: Recommended amount in brackets.)
____________________TOOTSIE POP MILK JUG DECALS (Limit 3 per case)
____________________UNDERWRITING LETTERHEAD (Limit 10 per case)
____________________WINDOW POSTERS (Limit 1 per case)
____________________SHAREHOLDERS CERTIFICATES (Limit 3 per case)
____________________CERTIFICATES OF APPRECIATION (Limit 3 per case)

SPECIAL NOTE: PLEASE READ CAREFULLY
In consideration of the preparation and distribution by the Foundation of canisters, aids, news releases and
promotion materials relative to TOOTSIE POP DAY, we do hereby agree to make a full and complete
financial disclosure of all TOOTSIE POP DAY collections to the Foundation and to utilize the net proceeds
thereof for the sole benefit of the blind and deaf projects, remitting our contributions promptly to
the Foundation 60% thereof, retaining the balance of 40% for local aid to the blind and deaf activities in
accordance with the established policy of the Lions of Illinois Foundation.
ALL FUNDS WILL BE GIVEN FOR AID TO THE BLIND AND DEAF PROJECTS ONLY.

SIGNED______________________________________TITLE______________________DATE_______
CLUB NAME_____________________________________________________DISTRICT 1-_________
DELIVER TO__________________________________________________________________________
ADDRESS_____________________________________________________________________________
CITY______________________________________________________STATE________ZIP__________