The Jean Remmel Little Society — Member Profile Please fill out the form below to send us your member profile so that we may welcome you into the Jean Remmel Little Society. * Required fields Contact information Name(s) * Age Age (spouse/partner) Address * City / State / Postal code * Country Telephone * Email * Society listing preference Southampton Hospital Foundation may include my (and, if applicable, my spouse's) name in the Jean Remmel Little Society listings. Neither amount nor designation will be included. I am honored to be included in the Jean Remmel Little Society; however, I prefer to remain anonymous. Gift information (optional) Please share, in confidence, more about your estate provision for Southampton Hospital Foundation. I have named Southampton Hospital Foundation as a beneficiary of my: Gifts Anyone Can Make Wills and Trusts Appreciated Securities Life Insurance Retirement Plans Gifts That Pay You Income Charitable Gift Annuity Charitable Remainder Unitrust Charitable Remainder Annuity Trust Gifts That Protect Your Assets Charitable Lead Trust Retained Life Estate Gift details (optional) Specific dollar amount Amount ($) Percentage of estate/account Percentage (%) Estimated current value of the gift ($) Gift use (optional) Unrestricted (general operations) Designated for a specific purpose Designation Send Member Profile Leave this field blank
