Legacy Gift Notification Form - Royal Columbian Hospital

I have arranged for a legacy gift to Royal Columbian Hospital Foundation*

Please choose one or more:

Gift in my will
Gift of retirement funds
Other

If other, please specify:

Recognition*

We would be honoured to recognize you on our Donor Wall and website as a Royal Circle member. Please let us know the exact wording you would like to use. Example: "Michael & Catherine Brown." or "Cynthia Wong."

Provide the exact recognition wording here, if applicable

I would like to receive:

Please select as many as you wish

E-newsletter (monthly by email)
Your Health Matters magazine (twice a year)
Invitation to events like Donor Appreciation Luncheon and Open House
A Royal Circle pin

I prefer to be contacted by:*

Donor information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email