Please provide the information below as it is required to give accurate examples of how a Gift Annuity will work for you!

How many lives would you like the gift annuity to cover? See ☼ Ex: A

One Life Birth Date ______________________Mo Day Year

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Two Life First Birth Date _____________________Mo Day Year

Second Birth Date _______________________Mo Day Year

Ex. A. For a one life Gift Annuity, it normally covers the life of the donor. For a two life annuity, it would cover the donor and spouse or significant other. Please enter the current value of what you are considering giving to give French Camp Academy, i.e. $50,000 cash or $50,000 stock.

$___________________

Please enter your cost basis (what you initially paid) for stock or other appreciated property.

$____________________

Please enter the following information so we can reach you.

Name__________________________

Phone_________________________

City___________________________ State____________________________

Zip___________________________ e-mail___________________________

We will contact you shortly with your examples. Remember, these are only examples and should not be used as legal or financial advice.

Please mail to:
French Camp Academy
Attn: Development Department
One Fine Place
French Camp, MS 39745