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Himebaugh Legacy Circle Membership Form

Your name(s) *

I/We have arranged for a future gift to the:

Community Foundation for the Fox Valley Region

Address *

Address

City

State/Province

Zip/Postal

Country

Phone Number *

Email *

Check all that apply.

I/We wish to remain anonymous.

Please contact me/us about charitable gift planning.

Please contact me with bequest language to provide to my attorney.

4455 W. Lawrence St
Appleton, WI 54914
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8:00am - 4:00pm
and by appointment

Confirmed in compliance with national standards for U.S. community foundations.