The 1889 Society Membership Form

The 1889 Society Membership Form

Thank you for your incredible generosity and for including Saint Anselm College in your future plans. You are shaping the future of education and leaving a lasting legacy for generations of students. We are deeply grateful for your commitment and vision. To ensure your legacy gift reflects your intentions, we kindly ask you to provide the information below. Your thoughtful contribution will make a meaningful impact, and we are honored to be part of your legacy.
Member Biographical Information (*Required )
Member Name:*

First NameLast Name
Class Year:
Date of Birth:
Saint Anselm College Affiliation: Please select all that apply.*

Saint Anselm College Alumnus/aCurrent ParentParent of AlumniGrandparentOther
Spouse/Partner:

First NameLast Name
Spouse/Partner Class Year:
Spouse/Partner Date of Birth:
Saint Anselm College Contact Information (*Required )
Address:*

Street Address 1

Street Address 2

City/TownState / Province

Postal / Zip CodeCountry
Primary Phone Number:*

Area CodePhone Number
Email Address:*

Confirmation Emailname@example.com
Planned Gift Intentions (*Required )
I will remember Saint Anselm College through my: (You may choose more than one option.)*

WillTrustBrokerage/Mutual FundLiving TrustLife Insurance PolicyRetirement Plan (IRA, 401(K), 403(b))Donor-Advised FundCharitable TrustCharitable Gift Annuity/Pooled Income FundSurviving Spouse/Partner's Will, TrustOther
This gift includes:*

CashReal EstatePersonal Propery (e.g. Art)Other
Saint Anselm College is a:*

Primary BeneficiaryContingent Beneficiary (This depends on another Beneficiary passing away.)
My gift is a: (It would be helpful for the college to know more about your gift. This information is optional.)

Fixed dollar amountResidual AmountSpecified Percentage
My estimate of the gift amount as of today's value is: (A range is fine.)
My gift is:*

Irrevocable (cannot be changed)RevocableRevocable, but I would like to know more about making it irrevocable. Please contact me.
I would like this gift to benefit Saint Anselm College as described: (e.g. Saint Anselm College Fund or endowment (cannot be spent), unrestricted to the college, restricted as stated etc.). Please note that the language of your Will or Trust ultimately governs the uses of your gift.*
Please note: If in future years circumstances have changed so significantly that it is no longer practical to use my gift in this manner, the trustees of Saint Anselm College may use the gift for other purposes that most closely fit my intent.
May we include your name in published lists of The 1889 Society? Neither the amount, the type, nor the designation of your gift will be included in such a list.*

YesUse anonymous
I understand the college’s interest in estimating long-term planning projections and I am proud to submit one of the following to document my intended gift plan: (Check all that apply. This is optional.):

Relevant page(s) from my Will or TrustBeneficiary Designation FormLetter from my attorney or financial plannerOther helpful information (e.g. name, address, and telephone number of trustee or executor/IRA company)
By clicking the box below, I am advising Saint Anselm College that the above provisions are in effect as of today’s date.*

Yes
This is not a binding legal document, and your information will be kept confidential.

If you have any questions, please contact:
Peter M. Labombarde, Senior Director, Planned Giving, at (603) 641-7228 or plabombarde@anselm.edu
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