AppalReD Legal Aid

Legacy Society Pledge

Bequest Intention Form

* First Name

* Last Name

* Email

* Address

* City

* State

* Postal Code

Phone

Birthday

If you are willing to disclose more information about your gift, please check all that apply.

Bequest Amount or Percentage

I wish to be listed as a Legacy Society member.

Do not list my name on public materials.

Please list me as (preferred name):

A Life and Legacy of Justice for All

Thank you for including AppalReD Legal Aid in your future planning and becoming a founding member of the Legacy Society. Please let us know your intentions via the form below. The Legacy Society recognizes friends who demonstrate their deep commitment to fighting poverty and creating equal access to justice.

Please take the time to fill out this form so we can better understand your intentions for your gift. The information you provide is not legally binding, and we understand that you may wish to change your gift in the future.

You may hit "sign up" at the bottom to electronically submit.

You may also mail this form to:

ATTN: Lorie Elam

AppalReD Legal Aid

120 N. Front Ave.

Prestonsburg, KY 41653