Legacy of Wishes Enrollment Form - Make-A-Wish Texas Gulf Coast & Louisiana

Legacy of Wishes
Enrollment Form

Thank you for your interest in enrolling in our Legacy of Wishes® program. Please fill out the information below and we will contact you as soon as possible.

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Title
Spouse's Name
Please Tell Us How You Would Like to Be Recognized
I Have Named Make-A-Wish as a Beneficiary Of My/Our:
Attorney's Name
I/We Have Named the Following as a Beneficiary in My/Our Estate Plan:
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If You Have Named More Than One Chapter or a Combination of a Chapter and the National Office, Please Select the Additionally Named Beneficiary:
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Contact You to Answer Additional Questions?