Lamplighter Society - Member Profile

Please fill out the form below, so we may welcome you into the Lamplighter Society.

Member - Biographical Information

(*) required field

First Name*

Last Name*

Date of Birth

NMH Class Year*

Please Specify*:

Spouse/Partner First Name

Spouse/Partner Last Name

Spouse/Partner Date of Birth

NMH Contact Information

Address*

Country

Street

City

Region

Postal Code

Email Address*

Confirm Email Address*

Home Phone*

Mobile Phone*

NMH Planned Gift Vehicle

Please Specify*:

NMH Planned Gift Details

This gift includes*:

Cash

Real Estate

Personal Property (e.g. art)

Other

Please Specify*:

Northfield Mount Hermon is a*:

Primary Beneficiary

Contingent Beneficiary

My gift is a (it would be helpful for the school to know more about your gift, although this information is optional):

Fixed dollar amount

Specified percentage

Residual amount

Fixed dollar amount:

Percentage:

My estimate of the gift amount as of today’s value is $:

My gift is*:

Irrevocable (cannot be changed)

Revocable

Revocable, but I would like to know more about making it irrevocable. Please contact me.

I would like this gift to benefit NMH as described*:

Please note: If in future years circumstances have changed so significantly that it is no longer practical to use my gift in this manner, the trustees of Northfield Mount Hermon may use the gift for other purposes that most closely fit my intent.

May we include your name in published lists of the Lamplighter Society? Neither the
amount, the type, nor the designation of your gift will be included in such a list*.

Yes

No

I prefer to remain anonymous

I understand the school’s interest in estimating long-term planning projections and will
submit one of the following to substantiate my intended gift plan (this is optional):

Relevant page(s) from my will or trust

Beneficiary Designation Form

Letter from my attorney or financial planner

Other helpful information (e.g. name, address, and telephone of trustee or executor/IRA company)

Please Specify*:

By clicking here, I am informing Northfield Mount Hermon that the above provisions are in effect as of today's date*:

Comment (Optional)