2021 Supporter Survey As we plan for the coming year, we want to get to know you better. What is important to you? How do you want to receive content and updates from the Foundation? How can we better serve you, our supporters, so that together we continue to make an impact in our community. 1. Supporter Information * Name: Title First Required Last Required Mr. Ms. Mrs. Miss Dr. Required * Email: Required Street 1: City/State/ZIP: City State ZIP AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AS FM GU MH MP PR PW VI AA AE AP AB BC MB NB NL NS NT NU ON PE QC SK YT None Required Phone Number: Date of Birth: Date of Birth: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 If you respond and have not already registered, you will receive periodic updates and communications from Ascension St. Vincent's Foundation. 2. Question - Not Required - In what ways do you interact with our organization? Please check all that apply. Please make up to 5 selections from the choices below. Attend special events Volunteer Sponsor Donor I follow you on social media 3. Question - Not Required - What is your preferred method of communication? Please make up to 4 selections from the choices below. Phone calls Email Mail Text 4. Question - Not Required - As a donor, what make you feel most appreciated? Please make up to 2 selections from the choices below. Personal calls or visits Birthday and Christmas cards Tour of our Mission in action Reports and updates Special Events 5. Question - Not Required - Which part of our mission is MOST important to you? Please make up to 2 selections from the choices below. Innovating chronic disease management Caring for women and children Access to healthcare for the poor and vulnerable Innovating care with technology Growing our facilities to serve more people and new communities 6. Question - Not Required - To what degree do you feel your gifts have made a difference in the community? Very impactful Moderately impactful Somewhat impactful Minimally impactful 7. Question - Not Required - Where does our charity rank compared to others you support? My top charity Within my top two charities Ranks in the middle of charities I support Ranks the lowest among charities I support Undecided 8. Question - Not Required - To what extent are we meeting your expectations for charitable organizations you are involved with ? Very well Moderately Well Not very well 9. Question - Not Required - When thinking about the future, how important is it that we further our mission? Very important Important Somewhat important Not very important 10. Question - Not Required - I would like to learn more about joining the Legacy Society via bequest and planned giving options. Yes No 11. Question - Not Required - If there is anything else you would like us to know, please share below: (Maximum response 255 chars, approx. 5 rows of text) Thank you for supporting the Mission of Ascension St. Vincent’s Foundation - a commitment to serving all persons, with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered holistic care, which sustains and improves the health of individuals and communities. Spam Control Text: Please leave this field empty
