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Yes
No, please do not include me/us in listings
Please indicate how you would like your name(s) to appear in the 1846 Legacy Society. (Please note the amount of your intended gift will not be published)

Name:
Date of Birth:
Spouse Name:
Spouse Date of Birth:
Phone Number:	( ) - Second three digits Last four digits
Email:
New Intention:	(I/We have not previously shared any information with Carroll University about this intention.)
Updated Intention:	( I/We have previously provided Carroll University with gift intention information. Using this form, I/We are providing updated information. This form replaces all previous shared documentation.)
I/We have established a gift to benefit Carroll University in the future by means of:	Will or Trust Beneficiary-Life Insurance Policy Beneficiary-Retirement Plan Bank, Investment, or other other Financial Account Other
The anticipated value of my/our Gift is/will be approximately:
I/We wish to designate our Gift to be used for the following purpose(s):	Unrestricted (Carroll Fund) Restricted (Please explain below) Please contact me/us to discuss designation for my/our intended gift.
If Restricted Please Explain:
Please provide a general description of the gift provision (Examples include: asset to be donated or description of intended use):
Recognition:	Yes No, please do not include me/us in listings Please indicate how you would like your name(s) to appear in the 1846 Legacy Society. (Please note the amount of your intended gift will not be published)
Signature(s):
Date:	Today

Confidential Intention Form