Gift Notification - American Lung Association

Please indicate below how your future gift intention will be fulfilled for the American Lung Association.*

A gift in my will or trust.
A percentage of an IRA or other qualified retirement plan.
A beneficiary of a life insurance policy.
A beneficiary of all or a percentage of funds remaining in my donor-advised fund
Other

Please specify:

Is this a percentage or a specific amount?

Please indicate the percentage and estimated value:

Please indicate the amount:

Please tell us about your gift designation:

Please provide the name or association with this person:

Please share how you would like to direct your gift.

How would you like your name to appear when we recognize your gift:

I wish to remain anonymous.

First Name*

Last Name*

Address

Address 2

City

State

ZIP

Country

Phone

Email*

Is there anything else you would like to share with us?

* denotes required field

Phone

This field is for validation purposes and should be left unchanged.