Create Your Legacy Today Please use this simple online form to submit your intention to join the 1865 Trust and create your legacy for Kappa Alpha Order, today. Personal, Chapter, and Contact InformationName First Last Initiation Chapter Initiation Year Date of Birth Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email PhoneAdd KAOEF as a Beneficiary*Bequest (Will or Living Trust)Retirement PlanCharitable TrustLife Insurance PolicyI have included the Kappa Alpha Order Educational Foundation (KAOEF) as a beneficiary of my trust or estate plan in the following way:Additional InformationPlease fill out the appropriate questions below based on how you are adding the KAOEF as a beneficiary. Bequest (Will or Living Trust)Answer the below questions if you selected Bequest.Type Percentage Residual Specific Contingency Other What is the percentage? Answer if your selection above was percentage or residual. Retirement PlanAnswer the below questions if you selected Retirement Plan.Type Percentage Other What is the percentage? Answer if your selection above was percentage.Charitable TrustAnswer the below questions if you selected Charitable Trust. What is the present size of the trust corpus? Please answer in $ amount. What is the KAOEF's percentage of remainder or lead trust? Please answer in % amount. Who is the Trustee (if other than KAOEF)? Life Insurance PolicyAnswer the below questions if you selected Life Insurance Policy. Policy Face Amount Please answer in $ format. Current Face Value Please answer in $ format.Type of Policy Policy Number Company Name Other Overall Estimated ValueThe amount must be a minimum of $10,000 for inclusion in the 1865 Trust. What is the estimated value of your gift? Please answer in $ format. Gift IntentionPlease help us know the how you would like to direct your gift. I intend for this gift to be used for: Unrestricted to the KAOEF for the greatest need. Restricted. IF Restricted, please let us know how. Will this be for leadership education, scholarships, internships, building and grounds, etc.Donor RecognitionPlease let us know how you would like to be listed in future publishing of the members of the 1865 Trust.Recognition and InclusionPlease include me as a member of the 1865 Trust with the opportunity to participate in special programs, events, and list my name for recognition.I prefer to remain anonymous. Please do not publish my name.Spouse Name First Last E-signature Please write your name as your recognition of your intention to join the 1865 Trust and that the information on this form is, to the best of your knowledge, true and accurate. NameThis field is for validation purposes and should be left unchanged.
