L'dor Vador Legacy Society Declaration of Intent Form

* Please select one:

I/We have already included a Legacy gift provisionI/We shall make a Legacy gift provision within the next 12 months

* Donor Signature(s):

By typing in your full name here, this acts as your digital signature. For multiple signatures, please separate names with a comma.

* Address Line 1:

Address Line 2:

* Address City:

* State:

* Zip Code:

* Mobile Phone Number:

Home Phone Number:

* Email:

* Date of Birth:

* I/We intend to make my/our gift to the permanent endowment fund of Or Ami through:

If "other," please specify here:

(Optional) The approximate value of my/our gift will be:

Please label your amount as a percentage OR monetary value in $.

I/We give permission to include my/our name(s) on a Legacy donor list to inspire and encourage others to join us. My/Our names should appear as follows:

I/We prefer to remain anonymous at this time

In addition to my Legacy gift to Or Ami, I would also like to make a gift to the following organizations:

Any comments or additional info you would like us to know?

Sat, April 20 2024
12 Nisan 5784

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Sat, April 20 2024 12 Nisan 5784