Legacy Giving Survey

1. Confidential Survey for Covenant House Vancouver

I hope that you will take a few minutes today to answer a short survey about about yourself. The survey is completely confidential and will not be shared with any other organizations other than Covenant House Vancouver. We respect your privacy and the purpose of the survey is for us to take care of our supporters in the best way possible. My contact information is at the end of the survey should you want to contact me.

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* 1. What is the main reason that you support Covenant House Vancouver?

I believe in the work that they do.

I have a personal connection to the cause.

Tax benefit.

Other (please specify)

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* 2. When thinking about the programs that Covenant House Vancouver offers, what area interests you the most?

Crisis Shelter

Community Support Services (Outreach & Daytime Drop-in)

Rights of Passage (Transitional Living)

Mental Health and Drug & Alcohol Counselling

Other (please specify)

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* 3. What category best describes your age?

19-30

31-40

41-50

51-60

61-70

71-80

81-90

90+

My date of birth is:

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* 4. Do you have a lawyer-prepared will?

Yes

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* 5. If after leaving legacies to family & friends have you named any charity in your will?

Yes

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* 6. Have you already left a gift in your will to Covenant House Vancouver?

Yes

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* 7. If you wish, please provide more details about your bequest:

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* 8. Would you like more information on planning a gift in your will for Covenant House Vancouver?

Yes

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* 9. If you requested more information, how would you like me to contact you?

Personal visit to my home or office.

Phone call.

E-mail.

By scheduling a tour of Covenant House Vancouver.

Other (Please Specify)

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* 10. Please tell us a little more about yourself:

Name: *

Address 1:

City/Town: *

State/Province: *

ZIP/Postal Code:

Email Address:

Phone Number: