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The Joseph Lee Heywood Society — Member Profile

Please fill out the form below to send us your member profile to be welcomed into the Joseph Lee Heywood Society.

Please note: All highlighted and starred (*) fields are required.

Name(s): *
Address: *
City/State/Zip: *
Telephone:
E-Mail: *

Please check one:

Carleton may include my (and, if applicable, my spouse's) name in the Joseph Lee Heywood Society listings. (Neither amount nor designation, if provided, will be included on the listing.)

Please list me/us as follows:

I am honored to be included in the Joseph Lee Heywood Society; however I prefer to remain anonymous. Please do not include my/our name in the Joseph Lee Heywood Society listings.

Please tell us, in confidence, more about your estate provision for Carleton College

I have named Carleton College as a beneficiary of my:

Will/trust for:

	a specified amount
	a specified percentage

Life Insurance Policy

Charitable Trust as Remainderman

IRA or Retirement Plan

Other (please specify):

My gift is:

	Unrestricted (General Operations)
	Designated for:

Estimated current value (optional)

as of (date)

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