Stock Gift Information
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Designation *
In Honor Of
If your gift is in honor of a specific staff member, please enter their name below.
Gift Note
If your gift is in honor or memory of a family member or friend, please list it below. If you would like the person or a family member to be notified of your gift (no amount will be included), please indicate their name and address below.
Stock Name *
Number of Shares
Approximate Value
Contact Information
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First Name *
Middle Name
Last Name *
Address Lines *
City *
State/Province *
Postal Code *
Phone *
Email *
Additional Information
Upon submission of this form, you will be provided with the FOCUS account and DTC information.
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This form was created inside of FOCUS.