National Building Museum

1.

Please provide us with the information below


*	Title:
*	First Name: Required
*	Last Name: Required
	Suffix:
*	Street 1: Required
*	Street 2: Required
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
*	Phone Number: Required
	Employer:
	Occupation:
	Date of Birth:	Date of Birth:
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*2.

Question - Required - I have made a provision for the National Building Museum in my estate plan.

3.

Question - Not Required - I have made an outright bequest in my will for the amount stated here.

4.

Question - Not Required - I have made an outright bequest in my will of the property detailed here.

5.

Question - Not Required - I have made an outright bequest in my will of real estate described further here.

*6.

Question - Required - Is this a conditional bequest of will?

7.

Question - Not Required - If yes, please specify the conditions listed in your will here.

8.

Question - Not Required - Is your gift a trust under will or to be funded by will?

9.

Question - Not Required - If yes, please let us know here if it is to be funded by a Charitable Remainder Trust or another arrangement.

10.

Question - Not Required - Does your planned gift designate the Museum as a beneficiary of a life insurance policy?

11.

Question - Not Required - If none of the above options describes your gift, tell us about it here.

12.

Question - Not Required - What is the aproximate value of your gift?

13.

Question - Not Required - Please describe any restrictions on your gift.

*14.

Question - Required - Would you like to be recognized for your gift?

Yes, you may include my name(s) in your list of Cornerstone Society members.

No, I request that my bequest and gift intention remain anonymous.

15.

Question - Not Required - If you would like to be recognized for your gift, how should we list you in our publications?

16.

Yes, I would like to recieve email from the National Building Museum


*	Email: Required
	Yes, I would like to receive e-mail from National Building Museum
	Email Format:
	Yes, I would like to receive postal mail from National Building Museum
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17.

Question - Not Required - I would like to recieve postal mail from the National Building Museum

18.

Question - Not Required - Please enter your mailing address