I - GENERAL INFORMATION
We would like to know about your organization so that we can research potential institutions -corporations, small businesses, services clubs, unions - to gather information for a framework for developing successful partnerships. Please answer the following as thoroughly as possible.
1. Organization Name .....................................................
2. Address...........................................
City............................................... Province............................... Postal Code................
Phone......................... Fax..................... Email.........................
Web Site........................................
3.1 Name and title of the person responsible for fundraising_____
3.2 Amount of time devoted to fundraising_______per week.
4. Check the status that applies to the person responsible for your organization's fundraising.
[Full Time] [Part Time] [Consultant/Self-employed]
5. Please check all that apply to your organization:
6. Fundraising Goals
Please (1) check all sources from which you receive funding; (2) indicate the approximate amount, if possible, that was given to your organization in your last fiscal year; and, (3) indicate what you would like to receive from each source in your next fiscal year.
Last fiscal year 19___ / Next fiscal year 19___
(4) Please check all of the following non-cash donations that you have received from institutions.
(5) Please specify examples such as length of time, skills given, etc. as appropriate.
II - PARTNERSHIPS WITH INSTITUTIONS
7. Have you ever developed a partnership(s) with an institution (i.e., corporation(s), small business(es), union(s), or service club(s)? By partnerships we mean a collaboration between your organization and an institution, for a specified period of time in support of a cause related to your work.
[Yes]. If [No], please go to Question 17.
8. Describe your most successful partnership with an institution by providing the following information:
Partnership Title_____
Partnership Goal_____
Institution_________ Department_________
Amount of funding received $_________ and/or Service/Product received_______
Time frame_______
9. How did you initiate this partnership? Please check all that apply:
10. How would you describe this partnership? Please check all that apply:
11. How was the institution involved? Check all that apply.
12. Describe any problems you encountered in your partnership reaching mutual goal(s)and objective(s):_____________
13. Were any of the following included in your partnership? Please check all that apply.
Please attach other relevant information, in particular, information about other successful partnership(s) with corporation(s), small business(es), union(s), or service club(s) you have had and can share with us.
14. Please describe a partnership you had that was not successful by providing the following information.
15. Please describe why the partnership was not successful in reaching mutual goal(s) and objective(s).
16. Please describe how it could have been a more successful venture.
III - PARTNERSHIPS FOR THE FUTURE
17. Would your organization be interested in developing partnerships with institutions - corporation(s), small business(es), union(s), or service club(s)?
If [Yes], please indicate what you hope to gain from future partnerships.
If [No], why not?
18. Please list any institution(s) that you may have thought of but have yet to seek out for partnerships.
19. What are your needs in terms of non-cash donations? Please check all that apply.
Expertise:
20. Is your organization looking for opportunities to partner with institutions? [Yes] [No]
If No, why not?______
IV - ETHICAL CONSIDERATIONS WHEN LOOKING FOR PARTNERSHIP OPPORTUNITIES
21. What type of institution(s) would your organization likely not accept funding from? Please check all that apply.
An institution that:
22. Does your organization have a written policy that limits from whom you will accept funding? [Yes] [No]
23. What does your organization need to develop partnerships with institutions? Please check all that apply.
Other Comments/Feedback:______
Please attach any policy statements that you can share with us about accepting donations.
Thank You.
Please sign and date this form allowing us to use the information provided above and provided in the focus group - if attending - to develop a framework for developing partnership(s).
Signature___________________ Date__________________
Title______________________