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Legacy Honor Roll Official Notification Form

 

Thank you for your thoughtful inclusion of FOEM in your estate plan. We respect your privacy and will note your membership in our Legacy Honor Roll unless we receive your directive that you would prefer to be anonymous. 

Please complete this form and then sign it. By doing so, you indicate to us whether you prefer anonymity or public recognition in the Legacy Honor Roll of donors. You may, at any time, update or change your recognition preference by completing and dating this notification form. Thank you very much. 

 

First Name*
Last Name*
Preferred Address*
City*
State*
Zip Code*
Daytime Phone*
Email*
 

Recognition Preference: We will list you in our Honor Roll and public recognition unless you select to be anonymous. 


OPTIONAL INFORMATION 

I/We have included the following in my/our estate plans
In the following manner


Details as follows
 
I/We have provided for
 

 

 

Please type your First and Last Name in the Electronic Signature field below.

Electronic Signature*
 

 

 All information provided will be regarded as strictly confidential and will be kept in secure files. 

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