Planned Gift Intention Form

Please submit this form to enroll in The Legacy Society for a Cure. A printable form is available as well. If you have any questions about planned giving or making any other type of philanthropic contribution, please contact Lauren Gainor, Assistant Vice President of Development, at lgainor@braintumor.org or 617-658-7034.

Personal Information

Have you been working with someone at NBTS regarding your planned gift? If so, please share a name here.

Name:(Required)

First Last

Date of Birth:(Required)

Address:(Required)

Street Address City State ZIP / Postal Code

Phone Number:(Required)

Email:(Required)

Planned Gift Details

As evidence of my desire to provide legacy support to the National Brain Tumor Society, I have made a provision for a gift in my estate plans.

It is my/our intent to leave a legacy gift to the National Brain Tumor Society through:(Required)

What is the specific amount of the gift?

What is the percentage of the residuary of your estate, trust, or retirement plan?

Please enter a number less than or equal to 100.

Please designate our gift to the following:(Required)

This gift is in honor of or in memory of:

Upload any supporting documentation for this legacy gift.

Max. file size: 256 MB.

Do you have an addition method through which you would like to leave a legacy gift to the National Brain Tumor Society?

It is my/our intent to leave a legacy gift to the National Brain Tumor Society through:(Required)

What is the specific amount of the gift?

What is the percentage of the residuary of your estate, trust, or retirement plan?

Please enter a number less than or equal to 100.

Please designate our gift to the following:(Required)

Upload any supporting documentation for this legacy gift.

Max. file size: 256 MB.

Purpose

Would you like to have your names published as part of The Legacy Society for a Cure?(Required)

If yes, please list how you would like your name(s) to be displayed:

Please consider sharing why it is meaningful to you to include NBTS in your estate plans.

I understand that this form is not legal or binding. If my planned gift intentions should change, I will notify the National Brain Tumor Society.

Signature (please type full name)(Required)

Today's Date(Required)

All information provided will be kept confidential. Please discuss your planned giving intentions with your professional financial and legal advisors. NBTS is a tax-exempt nonprofit organization recognized by section 501(c)3 of the Internal Revenue Code. Contributions are tax-deductible to the extent permitted by law.

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