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Questionnaire template

Donor Pledge and Feedback

Records a donor's gift amount, frequency and purpose, contact details and motivation, and rates the donation process.

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Nonprofit · Church. All Nonprofit templates

Questions in this template

Your Gift

  1. Thank you for choosing to support our work. This form records your gift and tells us how to put it to the best use.

  2. How much would you like to give today?

    Choose one from a list:

    • $25
    • $50
    • $100
    • $500
    • Another amount

  3. Please enter the amount you would like to give.

    Condition: Only when another amount was chosen

    A number from 1 to 1000000

  4. How often would you like to give?

    Choose one:

    • One time only
    • Monthly
    • Quarterly
    • Annually

  5. Which area of our work should your gift support?

    Choose one:

    • Education
    • Health care
    • Community development
    • Environment
    • Wherever the need is greatest
    • Other

  6. Which other area would you like to support?

    Condition: Only when Other was chosen

    Open answer

About You

  1. What is your name?

    Open answer

  2. What email address can we use to confirm your gift?

    Open answer

  3. How did you first learn about us? Select all that apply.

    Choose any that apply:

    • Social media
    • Friends or family
    • Our website
    • An event
    • Other

  4. Where else did you learn about us?

    Condition: Only when Other was selected

    Open answer

  5. What makes you want to support our cause?

    Open answer

Your Experience

  1. Overall, how satisfied are you with the process of making your gift?

    Choose one:

    • Very dissatisfied
    • Dissatisfied
    • Neither satisfied nor dissatisfied
    • Satisfied
    • Very satisfied

  2. Would you like to receive our newsletter with news about our work and its results?

    Choose one:

    • Yes
    • No