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Tower Hill School, 2813 W. 17th St. Wilmington, DE 19806

Tower Hill School – Stock Donation Gift Form This form contains information your broker will need to transfer stock to Tower Hill’s account. Please complete the form and fax it to Jane Bazydlo in the Development Office at 302.657.8373. You may also email it to Questions? Call 302.657.8353. Step 1: Electronic Delivery Information (for your broker) Tower Hill Brokerage Firm: M&T Securities Contact Information: 1.800.724.7788 (Option 2) Our Account Name: Tower Hill School Our Account Number: AZD946614 Our DTC Number: 0443 Step 2: Fax/Email us this Stock Gift Form Doing so ensures that your gift is processed quickly, accurately, and that your gift intentions are documented. Donor’s Name




Address ________________________________________________________________ This gift is for which Fund? ________________________________________________ (i.e. Annual Fund, Campaign for Athletics; see website for full listing)

Is this gift a pledge payment?


Stock Name

__________________ Symbol _____ # Shares or Approx. value ______

Stock Name

__________________ Symbol _____ # Shares or Approx. value ______

Special Instructions


____________________________________ Signature As of 8/28/2011

_____________________________ Date


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