Help Us Better Serve You!

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* 1. Of our five core programs that make up our Social Support Model, which ones are you most interested in? (Select all that apply.)

Social Empowerment

Education

Nutrition

Healthcare

Housing

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* 2. How often would you like to hear from us?

Once a week

Every other week (or bi-monthly)

Once a month

Less frequently than that

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* 3. How likely are you to recommend or share information with friends?

NOT AT ALL LIKELY

EXTREMELY LIKELY

0

1

2

3

4

5

6

7

8

9

10

0

1

2

3

4

5

6

7

8

9

10

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* 4. We would love to learn why you support Haiti. Would you be willing to share your story here?

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* 5. Optional: Provide your name and/or email

Name

Email Address