Feedback Survey What motivated you to give to The Village? (check all that apply)(Required) I wanted to make a difference in the community. I saw a news story. I saw a social media post. A friend asked me to. I have a personal connection to The Village. Other: Other description:What would motivate you to give again to The Village? (check all that apply)(Required) Hearing more stories from people who receive services from The Village. Being invited to Village events. Helping families around the holidays. Helping families around back-to-school time. Helping families with their basic human needs (e.g. food, clothing) Other: Other description:My overall impression of The Village is:(Required)Your name(Required) First Last Your email(Required) In addition to email, how should The Village communicate with you? Regular mail Text I prefer to not be contacted by The Village. Mailing address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone number:Your gift card will be emailed to the email listed above. Please check here if you would like to decline the gift card. The Village is holding a 2-hour in-person focus group for Village donors on November 13 from 4-6pm in Hartford. Participants will receive a $100 Visa gift card. Are you interested in participating?(Required) Yes No NameThis field is for validation purposes and should be left unchanged.
