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This is a confidential record. In order that we may include
you in our planned giving society, value your future gift for any campaign
purposes and properly thank you and acknowledge your gift, please fill
out the following information that applies to your future gift of a bequest
through your Will or Trust.
You
may fill this out online and then print it and mail or fax it to us at:
(910) 695-7501 FAX
The Foundation of FirstHealth
150 Applecross Road
Pinehurst, NC 28374