Legacy Intent Form

Name(Required)

First Last

Birthdate

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

I have named the Alley Theatre as a beneficiary of my estate

Yes

The current estimated value of my gift (or percentage) is

I would like to be listed with other legacy society members in Alley Theatre publications as follows

I would like to remain anonymous in Alley Theatre publications

Yes

Additional comments or questions

CAPTCHA

Nina Vance Legacy Society Intent Form