Copy of LevelUp Kids Feasibility Study Survey

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. In what ways have you been involved in LevelUp Kids?

Donor

Community Leader

Board Member

Institutional Funder

Other (please specify)

Question Title

* 4. How familiar are you with the work/mission of LevelUp Kids?

Question Title

* 5. Are you confident that these leaders make wise decisions regarding the direction and operations of LevelUp Kids?

Extremely confident

Very confident

Somewhat confident

Not so confident

Not at all confident

Comments

A CAMPAIGN FOR LEVEL UP KIDS

In addition to their school-based outreach, LevelUp Kids currently has separate offices for their dental and vision programs. As demand for their services grows LevelUp Kids must consider options for future office space to accommodate both their vision and dental programs. The new office space would include:

· 8 dental exams rooms, one specifically for sedation and necessary surgeries
· 2 optometry exam rooms
· Optical room for selection and fitting of eye glasses
· Secure parking for the service delivery vans
· Conference/multi-use room
· Space for partnerships with local social service agencies to provide a food pantry, hearing screenings and a wellness program

Question Title

* 6. Do you support these investments and feel like they advance the mission of LevelUp Kids?

Very Supportive

Somewhat Supportive

Neutral

Not Supportive

Not at all Supportive

Comments

Question Title

* 7. Do you have any questions about the potential project?

Question Title

* 8. The cost of LevelUp Kids proposed investments for the project could potentially total $5 Million. Do you think the proposed goal is attainable?

Very Attainable

Somewhat Attainable

Neutral

Not Attainable

Not at all Attainable

Comments

Question Title

* 9. Do you think our community would respond positively to a campaign for these initiatives?

Quite Positive

Somewhat Positive

Neutral

Not Positive

Not at all Positive

Comments

The table below represents the likely size and number of charitable gifts needed to complete the new building.

Question Title

* 10. If LevelUp Kids held a capital campaign of this size, do you believe there are individuals, businesses, or foundations that have the ability to give these kinds of gifts to LevelUp Kids?

Yes

Comments

Question Title

* 11. To whom would you look for the top three largest gifts to a potential LevelUp Kids campaign?

Question Title

* 12. Who do you think are the most important people in the community who should be involved in the Campaign?

Question Title

* 13. Would you be willing to help LevelUp Kids plan and/or implement a possible Capital Campaign? (If so, please provide your name and contact information.)

Yes

Name and Contact Information

Question Title

* 14. If LevelUp Kids held a capital campaign within the next 12 months would you consider making a pledge?

Yes

Unsure

Question Title

* 15. Is there a level on the above chart that reflects the size of a capital gift your family/business/foundation might consider pledging over 3 years? If so, please list the amount below.

(This gift would be over and above any annual support you offer to LevelUp Kids. The level you share today is not a commitment.)

Question Title

* 16. What would you expect your network (family, friends) could contribute?

Less than $2,500

$2,500 - $5,000

$5,000 - $10,000

$10,000 or above

Other (please specify)

Copy of LevelUp Kids Feasibility Study Survey

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. In what ways have you been involved in LevelUp Kids?

Question Title

* 4. How familiar are you with the work/mission of LevelUp Kids?

Question Title

* 5. Are you confident that these leaders make wise decisions regarding the direction and operations of LevelUp Kids?

Question Title

* 6. Do you support these investments and feel like they advance the mission of LevelUp Kids?

Question Title

* 7. Do you have any questions about the potential project?

Question Title

* 8. The cost of LevelUp Kids proposed investments for the project could potentially total $5 Million. Do you think the proposed goal is attainable?

Question Title

* 9. Do you think our community would respond positively to a campaign for these initiatives?

Question Title

* 10. If LevelUp Kids held a capital campaign of this size, do you believe there are individuals, businesses, or foundations that have the ability to give these kinds of gifts to LevelUp Kids?

Question Title

* 11. To whom would you look for the top three largest gifts to a potential LevelUp Kids campaign?

Question Title

* 12. Who do you think are the most important people in the community who should be involved in the Campaign?

Question Title

* 13. Would you be willing to help LevelUp Kids plan and/or implement a possible Capital Campaign? (If so, please provide your name and contact information.)

Question Title

* 14. If LevelUp Kids held a capital campaign within the next 12 months would you consider making a pledge?

Question Title

Question Title

* 16. What would you expect your network (family, friends) could contribute?

Question Title

* 17. What factors do you feel may prevent LevelUp Kids from conducting a successful Capital Campaign?

Question Title

* 18. Are there any other comments, suggestions, or questions you would like LevelUp Kids to consider?