Janeway Children’s Hospital Foundation
twitter
facebook
youtube
instagram
to pledge your support,
DONATE
NOW!
About
Donations at Work
Stories
Events
Corporate Takeover
How to Fundraise
Donors
Give to the Janeway
News
Contact
twitter
facebook
youtube
instagram
shop
About
About
back
About the Foundation
Janeway Foundation Educational Funding
About the Janeway Hospital
Board of Directors
Our Staff
Contact Information
Frequently Asked Questions
Donations at Work
Donations at Work
back
How your Donations Are Used
Stories
Stories
back
Our Kids
Our Team
Our Donors
Share Your Story
Events
back
Events
Telethon
Telethon
back
Telethon
How to Fundraise
Events
back
How to Fundraise
Donors
Donors
back
Giving Levels
Donor Bll of Rights
Give to the Janeway
Give to the Janeway
back
Individual Personal Giving
Corporate Giving
Community Giving
Planned Giving
Gift in Gratitude
Donor Updates
News
News
back
Publications
News
DONATE NOW
CONTACT US
Donor Questionnaire
Here at the Janeway Children’s Hospital Foundation we value your ideas and opinions. This survey will help us to provide you with information that you are most interested in. Please rest assured that any information you share with us will be kept in the strictest of confidence.
Where does the Janeway Children’s Hospital Foundation fall within your charitable giving plans?
The Number #1 Charity that I support
Included in the top 2 charities that I support
Included in the top 5 charities that I support
How long ago was your first donation to the Janeway Children’s Hospital Foundation?
Less than five years ago
Five to 10 years ago
10 – 20 years ago
More than 20 years ago
Over the past five years, what is the largest single donation you have made to a charity?
Less than $100
$100 - $249
$249 - $499
$499 and Over
Why do you support the Janeway Children’s Health and Rehabilitation Centre by donating to the Janeway Children’s Hospital Foundation?
I am/ was a patient
A member of my family is/ was a patient
A family friend is/ was a patient
Supporting the health care of our province’s children is a priority for me/ my family
If you were to choose, what funding areas within the Janeway Children’s Health and Rehabilitation Centre would most interest you?
Area of greatest need
Medical equipment needs of the Hospital
Pediatric Research
Staff Education/ Bursaries
Capital Campaign
Would you be interested to learn more about the Janeway Children’s Health and Rehabilitation Centre and the Janeway Children’s Hospital Foundation?
I would be interested in receiving print materials (brochures, newsletters, etc.)
I would be interested in taking part in a Hospital Tour
More than one million Canadians have made the generous decision to include a gift in their Will to support their favourite charities. Are you familiar with this type of charitable giving?
I am familiar with this type of gift option
I have heard about making a gift in my Will, but I do not know much about this option
I am not familiar with this type of gift option
Are you aware that leaving a gift in your Will, may help in reducing the taxes that your Estate will have to pay?
Yes
No
Have you ever considered making a gift, in your Will, to support the Janeway Children’s Hospital Foundation?
I have made a charitable gift, in my Will, to the Janeway Children’s Hospital Foundation
I intend to make a gift, in my Will, to the Janeway Children’s Hospital Foundation
I am considering a gift, in my Will, to the Janeway Children’s Hospital Foundation
I do not plan to make a gift, in my Will, to the Janeway Children’s Hospital Foundation
Would you visit a charity’s website to find out information about arranging a gift in your Will?
I have already looked for this information online
I would likely look for this information online
It is not likely that I would look for this information online
I do not visit charity websites
Would you like to receive information about arranging a gift in your Will to the Janeway Children’s Hospital Foundation?
Yes, I would like to receive information about arranging a gift in my Will
No, I am not currently interested in receiving information about arranging a gift in my Will
The following information will help us to get to know you better. We realize that these are very personal questions and we certainly understand if you do not wish to complete this section of the survey.
Gender
Male
Female
Marital Status
Single
Married
Common Law
Divorced
Widowed
Age
65 and Over
45 – 64
30 – 44
29 and Under
Specific Question(s)
Yes, I would like to have someone from the Janeway Children’s Hospital Foundation contact me to answer my specific question(s).
No, I do not have any specific question(s) at this time.
To ensure that we are able to provide you with the information you wish to receive, please complete the following contact information.
Name
*
First
Last
Home Phone
*
Work/Cell Phone
Email
*
Address
Street Address
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Additional Comments
Δ
This iframe contains the logic required to handle Ajax powered Gravity Forms.
About
Donations at Work
Stories
Telethon
Events
How to Fundraise
Donors
Give to the Janeway
News & Publications
Publications
Website Stories and Articles
Contact