Your answers help change lives SUPPORT CARE - Blind Foundation Survey 2018 Private and confidential Step 1 of 9 0% Please confirm and/or update your details below:Cons ID * RequiredInsert your personal ID number if it's not populated - You can find your ID number in your paper versionOrganisation NameName First Last AddressAddress 1Address 2SuburbCityPostal code Do you, or anyone you know, have a vision impairment, that is, an eye condition that cannot be corrected by glasses?YesNoIf yes, who? Myself A family member A friend A work colleague Other If other, please specify:Have you ever received services from the Blind Foundation?YesNoIf no, is there a reason you have not used the Blind Foundation services?I am unaware of the services the Blind Foundation offersI have an eye condition but I am managing well on my ownI have an eye condition but I am managing well with the assistance of friends and familyOther Other Has someone you know used the Blind Foundation services?YesNoIf yes, who?(Please tick all that apply) A family member A friend A work colleague Other If other, please specify: What first inspired you to support the Blind Foundation?(Please tick all that apply) I use/used the Blind Foundation’s services Someone I know is/has been supported by the Blind Foundation’s services I admire what guide dogs do I wanted to support a charity that was helping people in my community I value my own sight I might need the Blind Foundations services one day Other If other, please specify: Your support of the Blind FoundationThe following two questions may appear very similar. In the first question, we want to know how important something is to you. In the other, how satisfied you are.For each of the statements below, please rate how important each is with regard to your support for the Blind Foundation. (1 Not important at all - 5 Very important)Providing me with a feeling that I am part of an important cause12345Sending me information that shows who is being helped12345The frequency of requests for donations12345Providing me with a feeling that my involvement is appreciated12345Providing me with ways to get more involved e.g. volunteering12345The Blind Foundation effectively trying to achieve its mission12345Providing me with opportunities to make my views known12345 For each of the statements below, please rate how satisfied you are with the way the Blind Foundation addresses this for you. (1 Very dissatisfied - 5 Very satisfied)Providing me with a feeling that I am part of an important cause12345Sending me information that shows who is being helped12345The frequency of requests for donations12345Providing me with a feeling that my involvement is appreciated12345Providing me with ways to get more involved e.g. volunteering12345The Blind Foundation effectively trying to achieve its mission12345Providing me with opportunities to make my views known12345 If a friend or loved one was looking to make a donation to a charity and asked for your advice, how likely would you be to recommend the Blind Foundation as an organisation worth supporting?(1 Not likely - 10 Very likely)12345678910Please tell us why you gave that score: On a scale of 1 to 10, please indicate how much you agree with each statement. (1 Strongly disagree - 10 Strongly agree)I am a committed Blind Foundation supporter12345678910I feel a sense of loyalty to the Blind Foundation12345678910Blind Foundation is my favourite charity12345678910Can you tell us what inspired you to become a Blind Foundation Supporter? Leaving a gift to the Blind Foundation in your Will can have a lasting impact for New Zealanders who are blind or have low vision. Would you consider including the Blind Foundation in your Will, after you’ve made provisions for your own family and loved ones?I have already included the Blind Foundation in my WillI intend to include the Blind Foundation in my Will when I next update itI would consider including the Blind Foundation in my WillI have included other charities in my Will, but not the Blind FoundationI am not able to include the Blind Foundation in my Will at this time About YouYou are a valuable part of our community, and we want to reach out to more kind people like you who might be interested in supporting the Blind Foundation.To do so, we’d like to find out a little bit more about you.Are you male or female?MaleFemaleWhat is your year of birth?Full date of birth - must be dd/mm/yyyy formatFor those answers that have dd-mm-yy It is important for us to share stories to encourage others to use our services or to raise the funds needed to provide our services. At times we like to share stories about why our supporters donate to the Blind Foundation. Would you be willing to share your story with us?YesNoIf yes, can you please provide the best phone number for us to contact you?PhoneThis field is for validation purposes and should be left unchanged.