How many members of your household are including GLAD in their estate plan?

Contact Information

First Household Member

First Name

Last Name

Date of Birth

Phone

Email

Second Household Member

First Name

Last Name

Date of Birth

Phone

Email

Third Household Member

First Name

Last Name

Date of Birth

Phone

Email

Fourth Household Member

First Name

Last Name

Date of Birth

Phone

Email

Street Address

City

State

Zip

Recognition

Please let us know how you would like to be listed as part of GLAD's Legacy Society.

I/we prefer to remain anonymous

I/we prefer to be listed as:

Gift Type

Will/Bequest	Life Insurance
Retirement Assets	Charitable Gift Annuity
Charitable Trust	Other

Other details:

The approximate current value of this planned gift is:

Can be a dollar value, percentage, or text.

Please email supporting documentation to Carole Allen-Scannell at CAllenScannell@glad.org if you are comfortable and able to do so.

Gift Purpose

This gift is to be unrestricted and may be used to support GLAD’s highest priorities.This gift is to be used for the following purpose(s):

Signature (please type your name)

Date

Contact Information