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1. Select the type of gift(s) in which you are interested:

Charitable gift annuity
Support Avow and receive a fixed income for life.

Deferred charitable gift annuity
Support Avow and receive a deferred-income stream.

Charitable remainder unitrust
Support Avow and receive a variable-income stream.

Charitable remainder annuity trust
Support Avow and receive a fixed-income stream.

2. Select the type of asset(s) with which you are considering funding the gift:

Cash

Securities (stocks, bonds, mutual fund shares)

Real estate

Other (please specify)

3. Gift amount and cost basis:

Enter the dollar amount of the gift you are considering:

Enter the cost basis of the asset (if other than cash) you are considering funding the gift with:

4. Age(s) or birth date(s):

Enter the age or birth date for each beneficiary

Beneficiary 1:

Beneficiary is someone other than me or my spouse.

Beneficiary 2:

Beneficiary is someone other than me or my spouse.

5. Your information:

*Name:

Age:

Address:

City:

State/Province:

Postal Code:

Country:

Phone:

*E-mail:

Questions or Comments:

*All fields marked with the asterisk symbol (*) are required.