Legacy Society Member Profile

Please fill out the form below to send us your member profile to be included into Legacy Society.

Prefix:

First Name: *

Last Name: *

Address: *

City: *

State: *

Zip: *

Telephone:

E-Mail: *

Please check one:

I am honored to be included in the Legacy Society, however I prefer to remain anonymous. Please do not include my/our name(s) in Legacy Society listings.

I am honored to be included in the Legacy Society. You may include my (and, if applicable, my spouse's) name in Legacy Society listings. (Neither amount nor designation, if provided below, will be included on the listing.)

Please list me/ us as follows:

I have named American Red Cross as a beneficiary of my:

This information is optional.

My gift is:

Unrestricted

Designated for:

Estimated current value

as of (date)

You are here