USA Cycling Legacy Society

I/We wish to be recognized through membership in the USA Cycling Foundation Legacy Society, based on the following planned gift provision:

First Name *

Last Name *

Date of Birth * +

First Name *

Last Name *

Date of Birth * +

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Phone Number *

We would like to recognize your generosity and include your name as a member of our USA Cycling Foundation Legacy Society in various USA Cycling Foundation publications; the details about your future gift will remain confidential. *

Yes

No

Please Describe Your Planned Gift *

Although the following information is not required, your answers will greatly assist with the USA Cycling Foundation’s planning. The terms of your gift will remain confidential.

Describe the details of your gift plan that will benefit the USA Cycling Foundation, and/or attach a copy of the relevant documents:

Attach your documents here, please.

This gift is intended to benefit the USA Cycling Foundation, or a specific program, as described. We'll be in contact to discuss the details with you:

Advisor's Name

Phone Number

Email Address

Signature *

clear

Would you be interested in attending exclusive cycling events as part of the Legacy Society? *

Yes

No