We value your feedback.

We appreciate your input, as it allows us to better serve our members and the entire Ataxia community.

Step 1 of 12 - Q1

1) Do you believe in the National Ataxia Foundation's mission to accelerate the development of treatments and a cure while working to improve the lives of those living with Ataxia?

Yes

2) In what ways have you engaged with NAF? Please select all that apply.

I donate to NAF.

I have been/am affected by Ataxia.

A friend or family member has been affected by Ataxia.

I am a member of NAF.

I belong to a support group.

I have attended NAF's events.

I follow NAF on social media.

I’ve looked to NAF as a resource through webinars or the website.

Other

2aa) Please share more:

Please share more:

2a) Other - Please specify:

Please specify:

2b) How frequently do you engage with NAF?

How frequently do you engage with NAF?

Weekly

Monthly

Every few months

Yearly

Rarely or never

Other

2b-i) Other - Please specify:

Please specify:

3) We like to send supporters like you occasional emails with updates including videos, stories, and information about how we are making an impact on your behalf. Would you like to receive these updates? (You can opt out at any time.)

Yes, I want to receive occasional emails with updates.

Not at this time.

4) Which aspect of NAF's work is most meaningful to you?

Supporting promising Ataxia research

Providing vital programs and services for Ataxia families

Partnering with pharmaceutical companies in the search for treatments and a cure

Educating medical professionals and the general public about Ataxia

Advocating for those affected by Ataxia through expanding our partnerships with other organizations and policy makers

5) Was there an influential person in your life who inspired your appreciation of NAF?

Yes

5a) If yes, please indicate their relationship to you.

If yes, please indicate their relationship to you.

Parent/grandparent

Spouse/partner/significant other

Child/children

Other family member

Friend

Physician or nurse

Other

5a-i) Other - Please specify:

Please specify:

6) When thinking about future generations, how important is it to you that NAF continues to ensure that no one experiences Ataxia alone, until no one experiences Ataxia?

Of utmost importance

Very important

Somewhat important

Not very important

Not important at all

7) Supporters often recognize the need to support the National Ataxia Foundation in the following ways. Would you consider furthering our work in any of the following ways?

I already have	I am likely	I am somewhat likely	I am not likely

Donating online with a credit card

I already have

I am likely

I am somewhat likely

I am not likely

Mailing a check

I already have

I am likely

I am somewhat likely

I am not likely

Talking with a gift officer face-to-face or on the phone about making a substantial impact

I already have

I am likely

I am somewhat likely

I am not likely

Making a recurring contribution

I already have

I am likely

I am somewhat likely

I am not likely

Supporting the NAF Accelerate Fund, which provides critical annual resources for all of our program areas

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Donor-Advised Fund

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Family Foundation

I already have

I am likely

I am somewhat likely

I am not likely

Giving appreciated assets (such as personal or business stocks or bonds, land or rental real estate, etc.)

I already have

I am likely

I am somewhat likely

I am not likely

Leveraging my contributions to encourage others to give via a matching program

I already have

I am likely

I am somewhat likely

I am not likely

Transferring a portion of my IRA account to the National Ataxia Foundation (Qualified Charitable Distribution)

I already have

I am likely

I am somewhat likely

I am not likely

Making a charitable gift that provides a lifetime income to me or my loved ones

I already have

I am likely

I am somewhat likely

I am not likely

8) Many people like to include a gift to charity in their will or estate plan to support causes that are important in their life. Would you consider including a gift to the National Ataxia Foundation to benefit people living with Ataxia and their families?

I have included a gift for NAF in my will, trust, or by beneficiary designation.

I am interested in making this type of gift to NAF.

Not now, but in the future I would definitely be interested in making this type of gift to NAF.

Not now, but in the future I might possibly be interested in making this type of gift to NAF.

I am not interested in this type of gift.

8a) Please tell us about your legacy gift:

Please tell us about your legacy gift:

I planned this gift in honor or in memory of someone.

I would like this gift to go to a specific purpose.

NAF may use this gift where it will do the most good.

8a-i) Please provide the name of and/or association with this person:

Please provide the name of and/or association with this person:

8a-ii) Please describe the intended purpose:

Please describe the intended purpose:

Would you like us to provide additional information to help with your decision?

Easy Ways to Leave a Legacy

Gifts that Pay You Income

How to Create or Update Your Estate Plan

Tax-wise Ways to Make an Impact

Ways to Make an Impact Now

9) How does NAF rank in comparison to other non-profits you may support?

My top choice for charitable giving

Near the top of my list

Middle of my list

Bottom of my list

Not on my list

9a) Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of NAF?

Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of NAF?

Yes

9a-i) Please let us know the most convenient way to connect:

Please let us know the most convenient way to connect:

I would like to introduce the person(s) to NAF on my own.

I would like NAF to provide me with resources to share with the person(s).

10) We would love to hear your story. If you would like, please tell us why NAF's work is important to you.

11) About You (optional)

Age

Under 40

40 - 49

50 - 59

60 - 69

70 - 79

80 - 89

90+

Date of birth

Gender

Male

Female

Other/Nonbinary

Prefer not to specify

Please specify:

What is your marital status?

Married

Not married

Divorced

Widowed

Which of the following best describes your family?

No children

One child

Two or more children

Please tell us the highest level of education you completed:

High school graduate or equivalent

Some college

Associate's degree

Bachelor's degree

Advanced degree

Please select the option(s) that best describes your professional life.

Working full time

Working part time

Retiring within 5 years

Retired

Volunteering

Board member for a nonprofit

Business owner or entrepreneur

Self-employed

Disabled

Other

Profession:

Where do you serve as a board member?

Please check the box below if you would like to update your contact information.

I would like to update my contact information.

First name(Required)

Last name(Required)

Address

Address 2

City

State

ZIP

Country

Phone

Email(Required)

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