Legacy Gift Confirmation Form

Enter content here.

Legacy Gift Confirmation Form

We would love the opportunity to recognize your generosity and honour your gift. Kindly complete and submit the form below.

Details of your plans will be kept confidential and will enable us to recognize your generosity in a manner that meets your needs and expectations.

Donor Information

Full name *

Spouse full name (if applicable)

Address *

City *

Province *

Postal code *

Phone *

Email *

Mackenzie Health Foundation in my will *

I’ve already included Mackenzie Health Foundation in my willI intend to include Mackenzie Health Foundation in my will

My gift to Mackenzie Health Foundation is *

A specific amountA percentage of my estateThe residue of my estate after other bequests are madeA specific item of value

The intended, approximate amount of my gift in will is: $ ___________ or ___________% of my estate

Executor Information

Full name *

Address *

City *

Province *

Postal code *

Phone *

Email *

When wording your gift in will, please use our full legal name.
MACKENZIE HEALTH FOUNDATION | Charitable business number: 11930 6215 RR0001

Recognition

As a Legacy Society member, you will be the first to know about hospital news and activities, receive invitations to our exclusive events and be listed, with your permission, on our donor walls.

In recognizing my gift, I wish to remain anonymous

Authorize Mackenzie Health Foundation to list my name as (if not anonymous)

I wish for Mackenzie Health Foundation to report on the impact of my gift with the following contact information

Other

Full name *

Address *

City *

Province *

Country *

Postal code *

Phone *

Email *

Message for Future Generations

Your legacy gift will support the ultimate in health care now and into the future.
What message would you like to bestow to those who will benefit from your generosity?

I authorize Mackenzie Health Foundation to use my message for marketing purposes.