St. Luke's Magic Valley Medical Center

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Statement of Intent
St. Luke's Magic Valley Health Foundation

If you have made a provision for a gift to the St. Luke's Magic Valley Health Foundation, please let the Foundation know by completing and emailing this form. A Foundation staff member will contact you. Thank You!

Salutation

First Name * MI

Last Name *

Address *

Address (Cont.)

Address Type:

City * State * Zip Code *

Day Phone * Evening Phone

Email Address: *

Please enter your email address again for confirmation.

Email Address Email Type:

I/We have made the following provision for a gift:
Bequest Charitable Remainder Trust Life Insurance Other

To recognize this gift I/we give the Foundation authorization to list the following as members of the Legacy Society.

Salutation

First Name MI

Last Name

I/we have provided for a gift but do not wish to be listed as a member of the Legacy Society.

I/we wish to consider a deferred gift and would like to discuss the Foundation’s programs and services with a Foundation representative.

Please contact me at the day and time noted below.

Best time to reach you. Day of week: Time:

This Statement of Intent is for information only and is not legally binding.

Ways to Give

Magic Valley Medical Center