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Contact Information
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First Name:
Middle Name:
Last Name:
Enter address, city, state and postal code
as filed with your financial institution.
Address:
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Gift Information
Fund:
Please list fund name in the comments section if you have chosen a fund which specifies to: "lists fund name below".
Amount: $
Frequency:
 
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How did you hear about the community foundation?
   
Would you like more information about establishing an endowment fund with the NICF? Yes No
   
Would you like more information about planned giving or estate planning? Yes No

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CVV2: CVV2 Information
Expiration Date: mm/yyyy

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