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Local Chapter-Groups Member Survey

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Hadassah Member Survey

[name of your chapter/group]

Chapter Website or email address

                           This is your Hadassah. Help us get to know you better!

 

Please complete and return this survey to            [email]___________________. If you have any questions or suggestions, please contact ____[name]___________                   at _____[email/phone]______________. Thank you in advance for your participation.

           

Name                                                          Phone (day)                                   (eve)

           

Email Address                                        Cell Number                                          Birthday

 

What is your current membership status?  

º Annual Member          º Life Member              q Associate Member      q Not yet a member

 

What made you decide to become a member of Hadassah? (Can revise to match your community)

q Support the mission                 q Friend asked                          q Gifted by______________   

q Connection to Israel               q Transfer from another community

 

q Support research for:             q Breast Cancer           q Stem Cell                   q Diabetes

                                                 q Ovarian Cancer         q Multiple Sclerosis        q Parkinson’s Disease

q Advocate for health issues at the national and local level           q Support Hadassah College Jerusalem q Support Children at Risk - Youth Aliyah         q Support education on health & related issues 

q Participate in Al Galgalim        q Other____________________________________________

 

What age category applies?

q Under 21       q 21-30           q 31-45            q 46-55            q 56-64            q 65+ 

 

What is your profession and background:

_______________________________________________________________________

 

What is/are your area(s) of expertise?

q Computer                  q Financial        q Medical         q Graphics        q Web/Blogs

q Public Speaking          q Marketing      q Leadership Development        q Jewish Education

q Fundraising                q Writing          q Other                                                                                   

 

How often would you be interested in participating in a Hadassah event?

q Several times a month            q Once a month            q Special events only        q Not at all

 

In which activities or programs would you most likely participate? (Check one or more)

q Book Reviews                   q Career Issues                 q Environmental programs        

q Issue Advocacy                 q Finance                          q Family Events            q Couples Events

q Daytrips/Travel                 q Social Events                  q Health/Women’s Issues         

q Community Volunteering    q Other                                                                             _____

 

What time of day are you most often available for Hadassah activities? (Check one or more)

q Weekday Mornings                 q Weekday Afternoons              q Weekday Evenings    

q Sunday Mornings                    q Sunday Afternoons                 q Sunday Evenings                   

 

Would you like to volunteer with Hadassah?           q Yes               q No

If yes, would you:          q Assist with phone calls            q Provide home for meeting/event           

q Help with short-term project   q Help with long-term project     q Other                                               

 

Have you ever held a chapter or group board position?

q Yes q No   q If yes, which position(s)? ___________________________________________________   

 

 

We care about the environment. Would you be willing to receive communications via email?

q Yes               q No

 

Please check off any social networking site you use.

q Facebook                  q Twitter                      q LinkedIn                    q Other___________________

 

Please share some of your family demographics with us:

q Single                        q Married (Husband’s name_____________________________________)

Children: q Ages 0-5     q Ages 6-12      q Ages 13-18    q Adult Children

 

How long have you lived in this area? ___________________________________________

 

Do you belong to a synagogue?___________Which one?__________________________

 

Are you active with other organizations in town? q Yes - Which ones?________________     q No 

 

             Please share any of your special talents or areas of expertise you’d be willing to share:   

________________________________________________________________________________________________________________________________________________

             Please tell us if you have any thoughts or ideas for an interesting program or event:

________________________________________________________________________________________________________________________________

 

Please share the name(s) and contact information of prospective members:

______________________________________________________________________________________________________________________________________________________

 

 

Thank you for participating in this survey. 

 



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