Gift Intention Form

Mary Bird Perkins Cancer Foundation: Gift Intention Form

Name (Required)

Additional Name (Optional)

Email (Required)

Phone Number (Optional)

I/we have made a provision to leave a legacy to Mary Bird Perkins Cancer Foundation through my/our:

Will

Trust

Life Insurance

Retirement Plan Assets

Charitable Gift Annuity

Other

If you selected "Other" or would like to share the value of your gift, please contact Carter Rose Stone at (225) 215-1298 or cstone@marybird.com.

Please use my gift for the following purpose(s):

Mary Bird Perkins Cancer Foundation's greatest need (unrestricted)

Mary Bird Perkins Cancer Foundation's general endowment

Specific purpose or fund (Contact Carter Rose Stone at (225) 215-1298 or cstone@marybird.com for details.)

Membership listing (please check one):

Please include my (and, if applicable, my spouse's) name in your society listings. Neither amount nor designation, if provided, will be included on the listing.

Please list me / us as follows:

I am honored to be included in your society; however, I prefer to remain anonymous. Please do not include my/our name in your society listings.

By signing this member profile, I reaffirm my commitment to Mary Bird Perkins Cancer Foundation. However, this letter shall not be binding upon my estate, and the information contained herein shall be used for Mary Bird Perkins Cancer Foundation purposes only.

Digital Signature

Digital Signature (Required)

Date Signed (Required)

Leave this field blank.

The information you share will be kept strictly confidential. By completing this form, you may receive communication and planned giving email news from Mary Bird Perkins Cancer Foundation. You can unsubscribe any time.

You can make a difference!

Contact Us eNewsletter Sign-up

4950 Essen Lane, Baton Rouge, LA 70809
(225) 215-1298
www.marybird.org

Facebook Twitter Instagram LinkedIn

Information contained herein was accurate at the time of posting. The information on this website is not intended as legal or tax advice. For such advice, please consult an attorney or tax advisor. Figures cited in any examples are for illustrative purposes only. References to tax rates include federal taxes only and are subject to change. State law may further impact your individual results. Annuities are subject to regulation by the State of California. Payments under such agreements, however, are not protected or otherwise guaranteed by any government agency or the California Life and Health Insurance Guarantee Association. A charitable gift annuity is not regulated by the Oklahoma Insurance Department and is not protected by a guaranty association affiliated with the Oklahoma Insurance Department. Charitable gift annuities are not regulated by and are not under the jurisdiction of the South Dakota Division of Insurance.Privacy Policy | Cookie Policy

Personal Estate Planning Kit Request Form

Please provide the following information to view the materials for planning your estate.

First Name First name is required

Last Name Last Name is required

Email Address Please include an '@' in the email address

Checkpoint

eBrochure Request Form

Please provide the following information to view the brochure.

First Name First name is required

Last Name Last Name is required

Email Address Please include an '@' in the email address

Checkpoint