Name:

Email:

1. Have you heard about our Annual Mother’s Day Royal Picnic?

Please Select Yes No

2. Have you attended the Picnic?

Yes - which year/s

Not as yet

3. Do you ever log on to our website?

Please Select Yes No

4. If so, what did you do on the site?

Read about the Foundation Made a donation Searched for events information Looked for information about the hospital

5. Do you use the internet to donate?

Yes, now and then Yes, regularly No, but have considered it

6. Would you rather donate:

Via the Foundation Newsletter Over the telephone Using the fax In person

7. Have you raised funds for

The RHW Foundation Other charities If yes, what did you do (e.g. type of fundraising or event)?

8. When reading our Newsletter, do you have a good understanding that your donation makes a difference to our hospital?

Please Select Yes No

9. Are you aware of all the services at the ‘Royal’?

Please Select Yes No

10. Is there a special area within the hospital you would like to support?

No, I would like my donation to go to the area that has the greatest need Yes, I am keen in supporting the following

11. Has someone in your family, extended family or a friend

Delivered a baby at the ‘Royal’ Or knows of someone who has been born at the ‘Royal’ Or used other services at the ‘Royal’?

12. Have you heard about our ‘Royal Baby Stars’?

Please Select Yes No