download the Pledge Form - MSF

Médecins Sans Frontières Hong Kong
Legacy Program
Thank you for your kind support of MSF’s worldwide medical humanitarian relief work. Your promise of
future support is deeply appreciated by us, by our field workers in the frontline, and by the people MSF
serves. A bequest is one of the most effective ways you can help MSF prepare for the future, enabling us
to continue providing crucial medical aid where and when it is most needed.
Please fill out the following information:
I have made a bequest to MSF-HK.
Contact person name and telephone number: __________________________________
I have named MSF-HK as a beneficiary of my life insurance policy.
Policy No: _______________________________________________________________
Bequest Amount: _________________________________________________________
I intend to leave MSF-HK a legacy, please follow up with me.
I am interested in legacy giving and would like to receive more information.
I intend to name MSF-HK in my life insurance policy, please follow up with me.
I would like to know more about MSF. Please include me in your mailing lists.
Name: _________________________________________________________________________
Telephone: _____________________________________________________________________
Email: _________________________________________________________________________
Address: _______________________________________________________________________
MSF Donor ID (if applicable) no: ____________________________________________________
Language preference:
□ English
□ Chinese
* Please return the completed Pledge Form to MSF-HK at 22/F Pacific Plaza, 410-418 Des Voeux Road
West, Sai Wan, Hong Kong, or fax it to (852) 2337 5442