NY-NJ Trail Conference Online Stock Transfer Form

Donor's Address:

City:

State:

Zip Code:

E-mail:

Donor wishes to remain anonymous

Securities Gifted

Date of Transfer

Number of Shares

Name of Security

Please select how you would like to designate your gift

General Fund

LASF

Outdoor Fund

Other:

Transferring Broker

Name

Firm

Telephone

City, State

Additional Information