JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Getting to Know You
Here at SHIM we love our neighbors, and we would like to know you better! We are grateful for your support and appreciate your dedication to helping your community. Please complete this form if you would like to share more information about yourself.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
What is your preferred method of communication?
*
Email
Phone
Direct Mail
Phone and Email
Email and Direct Mail
Phone and Direct Mail
No Preference
Preferred Phone Number
Your answer
Preferred Email Address
Your answer
What would you like to see more of (ex. details about programs, pictures of clients, financial details)?
Your answer
How often would you like to hear from SHIM?
*
Weekly
Monthly
Every 2-3 months
Every 6 months
Once per year
Other:
How do you contribute to SHIM?
In-kind
Monetary
Both
Other:
Clear selection
We are grateful for your generosity. What makes you choose SHIM as the recipient of your gifts?
Your answer
Which programs do you choose to support?
No preference
Food Pantry
Youth Programs
Direct Assistance
Back to School
Other:
Clear selection
How much of an impact do you feel your gift has?
Little Impact
1
2
3
4
5
6
7
8
9
10
Great Impact
Clear selection
How did you hear about SHIM?
Friend or family member
Congregation
Search engine
Social media
Print media
Email
Other:
Clear selection
What other causes do you support?
Your answer
How old are you?
under age 18
18-24
25-34
35-44
45-54
55-64
65+
Clear selection
Any additional comments?
Your answer
Thank you for completing this survey! We appreciate the chance to know our neighbors better.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
