Legacy Society Enrollment Form - Wild Rivers Conservancy

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Name(Required)

First Last

Name

First Last

Address(Required)

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

Email(Required)

Phone(Required)

Recognition(Required)

During our lifetime: Please use our names during and after our lifetimes to encourage others to support the work and mission of Wild Rivers Conservancy

After our lifetimes: Please use our names after our lifetimes to encourage others to support the work and mission of Wild Rivers ConservancyChoice

Anonymous: We wish to have our generosity remain anonymous to support the work and mission of Wild Rivers Conservancy

Please select how if and how you’d like to be recognized

Gift Type(Required)

Will provision (bequest)

Trust provision

Beneficiary of a Life Insurance Policy

Beneficiary of a IRA, 401k or other retirement plan

Beneficiary of an investment/brokerage account

Other

Estimated Value of Gift(Required)

Gift Designation(Required)

Wild Rivers Conservancy’s discretion (unrestricted)

Wild Rivers Conservancy Endowment Fund held at the St. Croix Valley Foundation