How You Can Help > Celebration Circle Form

Confidential Statement of Intent

First Name*:

Last Name*:

Address*:

City*: State*: Zip Code*:

Home Telephone*: Work Telephone:

Email*:

I/we have made the following provision for a planned gift to the To Celebrate Life Breast Cancer Foundation:

Bequest	Charitable Remainder Trust
Life Insurance	Charitable Lead Trust
Retirement Plan Designation
Other:

In recognizing the gift, To Celebrate Life Breast Cancer Foundation is authorized to list the following name(s) as members of the To Celebrate Life Celebration Circle:

I/we have made provision for a gift but prefer confidentiality and wish to be an anonymous member of the To Celebrate Life Celebration Circle.
It is my/our intention that this gift be an endowed (permanent) gift to To Celebrate Life Breast Cancer Foundation.
I/we wish to consider a planned gift and would like to be contacted to discuss my gift.

If you prefer, you can print and mail this form to:

To Celebrate Life Breast Cancer Foundation
Celebration Circle
P.O. Box 367
Kentfield, CA 94914

Or fax it to:415.366.1970

Or email it to: kathy.meyer@tocelebratelife.org

* indicates a required field



©2012 To Celebrate Life Breast Cancer Foundation 501(c)(3) non-profit organization	P.O. Box 367, Kentfield, CA 94914 \| (415) 455-5882 Technical issues: webmaster@tocelebratelife.org
Your privacy is important to us. To Celebrate Life Breast Cancer Foundation collects the data you submit through our website and does not share it with anyone or any other agency. To Celebrate Life Breast Cancer Foundation does not sell any personal information that it collects. We invite you to review our privacy policy.