Thank  
you  for  leaving  the  gift  of  a  lifetime  to  *Bernheim  Arboretum  and  Research  Forest  and  welcome  
to  the  Echo  Society!  We  are  honored  to  help  you  ensure  a  legacy  that  will  echo  throughout  nature.    
*Legal  name  of  our  organization  for  planned  giving  purposes  is  the  Isaac  W.  Bernheim  Foundation.  
Name  (as  you  prefer  to  be  called):  
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Name  (for  recognition  purposes,  if  different  than  above):  
  ____________________________________________________________________________________    
Address:  _____________________________________________________________________________    
City,  State  &  Zip  code:  __________________________________________________________________    
Phone:  _____________________________________________________  
Email:  ______________________________________________________  
  
Birthdate:  ___________________________________________________  
Have  you  designated  your  gift  for  a  specific  purpose?  Please  explain.  
_____________________________________________________________________________________
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Your  commitment  qualifies  you  for  our  Echo  Society.  To  publicly  thank  you  for  your  commitment  to  
Bernheim  and  to  inspire  others  to  make  similar  planned  gifts,  we  like  to  list  society  donors  in  our  
publications,  please  select  a  preference.    
  
_  My  Name  may  be  listed  
_  I  prefer  this  gift  to  remain  anonymous  
_  I  prefer  all  my  giving  to  remain  anonymous    
  
Optional  Information    
While  you  are  not  required  to  provide  the  following  information,  we  find  it  helpful  to  better  understand  
our  donors  and  their  wishes  to  be  good  stewards  of  their  gifts.  Nothing  you  disclose  here  is  legally  
binding.  
  
Type  of  Gift  (check  all  that  apply):  
_  Will        _  Insurance  Policy    __Retirement  Plan    
_  Other  Asset  (please,  specify):  ___________________________________________________________  
Please  list  any  contingency  
details:_______________________________________________________________________________
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We  understand  circumstance  can  change  –  please  let  us  know  if  yours  do.    
  
  
Signature:  _____________________________                                    Date:  ___________________________