Confidential Pledge

If you would like to leave a legacy to Viva!, it will be of enormous help to us in planning for the future if you would let us know the nature of your gift. This pledge is only a declaration of your current intentions and is in no way binding!

My gift to Viva! is in the form of:

[  ] the entire residue of my Estate
[  ] part of the residue of my Estate
[  ] a percentage of my Estate
[  ] a cash gift (pecuniary legacy) of £______
[  ] a non-money specific gift of the following asset(s)
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[  ] I have now included Viva! in my Will
[  ] I have not yet included Viva! in my Will, or made a Will, but intend to do so

Title: _________ First Name: _____________________ Surname: ________________________

Address: _________________________________________________________________________

________________________________________________________________________________

____________________________Postcode: _________________Tel ________________________

Signature ______________________________

Date __________________________________

Email _________________________________

Please return this pledge to Juliet Gellatley, Founder & Director, Viva!, 8 York Court, Wilder Street, Bristol BS2 8QH.