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Irvin Stewart Society Membership Form

Please fill out the form below to join the Irvin Stewart Society.

* Indicates a required field

Name(s): *
School/Class: *
Address: *
City/State/Zip: *
Telephone:
E-Mail:

Please check one:

West Virginia University Foundation may include my (and, if applicable, my spouse’s) name in Irvin Stewart Society listings and on this website with other members' names. (Neither amount nor designation, if provided, will be included on the listing.)
Please list me / us as follows:
I am honored to be included in Irvin Stewart Society, however I prefer to remain anonymous. Please do not include my/our name in Irvin Stewart Society listings.

The following information is important, but is optional:

Please tell us more about your estate provision for West Virginia University's benefit.

I have named West Virginia University Foundation as a beneficiary of my:

Will/trust for:
a specified amount
a specified percentage
Life Insurance Policy
 
Charitable remainder trust
IRA or retirement plan    
Other (please specify):

My gift is:

Unrestricted Designated for:
Estimated current value as of (date)

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