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Guardians' Circle Enrollment Form

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Guardians' Circle Enrollment Form

Contact Information (*Required)

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

Please check one:

I/We have included Children’s in my/our will or living trust.
I/We have included Children’s as a beneficiary of my:
IRA or retirement plan
Bank or brokerage account
Commercial annuity
Life Insurance Policy
Charitable trust
Other (please specify):

Additional information you wish to provide:


Recognition options:

Please recognize me/us as a Guardians’ Circle member on the Guardians’ Circle Wall at Seattle Children’s Hospital.
I/We wish to remain anonymous.




This is not professional tax or legal advice. Donors must consult their tax and legal advisors regarding their specific situation.