Heritage Society Enrollment Form

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Heritage Society Enrollment Form

Mount St. Joseph University Heritage Society Enrollment Form

This form is to notify the University of Mount St. Joseph, an Ohio nonprofit corporation, located at 5701 Delhi Road, Cincinnati, Ohio 45233, that I/we,
of
Preferred Phone: Home Work Cell
have made a provision in my (please check the appropriate item):
Will
Living Trust/Pour Over Will
Charitable Remainder Trust
Charitable Gift Annuity
Retirement Asset
Deferred Compensation Plan
Individual Retirement Account
Other

For a gift of $ or
as an unrestricted gift
to be used for the purpose/program at Mount St. Joseph University. At the time my/our gift is received, should there be no program related to my area(s) of interest, my/our gift will fund the program in greatest need, as determined by the President of Mount St. Joseph University.

I/We would like to be recognized as a member of the Heritage Society.
Please list my/our name(s) as follows:
I/We would be willing to be interviewed for a donor profile story in the future.
Please list me/us as an Anonymous Donor.

You may contact me. Best method of contact (check all that apply): Email Phone Mail

When my/our gift has matured, I/we understand that based on the size of the gift and the current recognition policy in place at that time, my/our gift may merit recognition with a plaque (e.g., In grateful appreciation of the faculty of Mount St. Joseph University or In loving memory of Sister Charity). Should that be the case, it is my/our wish for the plaque to state:

5701 Delhi Road, Cincinnati,
OH 45233-1670

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