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Phillips Society Membership Form

Phillips Society Membership Form

Required fields are marked with an *
The Phillips Society recognizes and celebrates friends who create a lasting legacy of giving that advances medicine and scientific discovery by including Massachusetts General Hospital in their estate plans.

The information you provide here about your legacy gift for Mass General is confidential but will ensure that our records are accurate and that we use your gift in the way you intend. We understand that the value of future gifts and the provisions themselves may change over time. Completing the Phillips Society membership form carries no obligation on your part. If you decide to change your plans in the future, simply notify the Office of Planned Giving.
 
This question requires a valid email address.
This question requires a valid number format.
4. Address
5. My/our future gift is from: *This question is required.
6. We welcome any copies of legal documents naming the Mass General as a beneficiary.
The specific amount or percentage of my estate estimated to be worth:
8. My/our future gift will support: *This question is required.
  • * This question is required.
9. Check one if applicable:
10. Allowing us to acknowledge your support publicly is like giving twice. Your gift supports the future work of Mass General, and your name provides an example for others to follow. Since you've remembered Mass General in your estate plan, please select one option below * *This question is required.