Legacy Society Membership Form

Legacy Society

Confidential Membership Acceptance Form

Name(Required)

Prefix First Last

I/We wish to be recognized with membership in the Legacy Society and would like to join with other members to ensure the continued growth of Atlanta-Fulton County Zoo, Inc. dba Zoo Atlanta.

Email(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I have provided for the future of Zoo Atlanta in the following manner:

Bequest through will or trust

Bequest of retirement plan assets

Charitable lead trust

Gift of life insurance

Charitable remainder trust

Other (Listed below please find a copy of the page or paragraph that describes my future gift provision.)

Description of future gift provision:

The estimated current dollar value of my gift: (optional)

My gift is to be used as follows:

If designation is not specified, Legacy Society gifts will go towards our endowment fund at the discretion of the Zoo Atlanta Board of Directors and management for the area of greatest need.

Please list how you would like your name(s) to appear for recognition:(Required)

Publish name

You have my permission to include my name in published lists recognizing Legacy Society members such as on the Zoo’s in-park donor recognition kiosk and in the Annual Report.

Publish name

You have my permission to use my name in external published articles (publications, newsletters, website) describing my gift and its positive impact on the future of Zoo Atlanta.

Publish name

I prefer that you do not include my name in published lists recognizing Legacy Society members. Please consider me an anonymous donor.

Consent(Required)

I consent to join Zoo Atlanta’s Legacy Society.

This field is for validation purposes and should be left unchanged.