Planned Giving Information Request Form

The Planned Giving office is available to work with donors and their advisors to determine the type of gift that will be most beneficial to them or their loved ones. Fill out the form below and we will contact you to follow up.

Click here to see our Privacy Policy.

Fields marked with an asterisk (*) are required.

First Name*:

Last Name*:

Address Line 1:
   
Address Line 2 (if needed):


City:    State/Territory:    Zip:

Country:

E-mail address:
      

Telephone*:

Preferred method of contact:    phone    email    mail

Regarding: Outright_Gift Bequest Charitable Gift Annuity Charitable Remainder Trust Retained Life Estate Charitable Lead Trust Other

Notes or comments:

I have already made a planned gift to the Keck School of Medicine of USC
and would like to be added to the Keck Founders Circle.