* 1.
Question - Required -
Which of the following best describes you?
I have ALS
I am a Spouse/Significant Other of a person with ALS
I am a Daughter/Son of a person with ALS
I am a Parent of a person with ALS
I am a Relative of a person with ALS
I am a Caregiver (unrelated) of a person with ALS
I am a Healthcare Provider of a person with ALS
I am a Coworker of a person with ALS
I am a Friend of a person with ALS
I am a Student of a person with ALS
I am an Interested Party in the ALS cause
* 2.
Question - Required -
Are you a new or returning walker?
Select
New
Returning
* 3.
Question - Required -
Did you register online through the Walk Website?
Select
Yes
No
4.
Question - Not Required -
If you answered YES to question #3, do you have any suggestions for the registration process or did you have any issues we can improve upon next year?
(Maximum response 255 chars, approx. 5 rows of text)
* 5.
Question - Required -
I saw/heard the Walk advertised...
Please make at least 1 selection from the choices below.
6.
Question - Not Required -
Did you participate in Team Week challenges?
Select
Yes
No
7.
Question - Not Required -
How did you hear about the Team Week challenges?
Email
Facebook
Team Captain
8.
Question - Not Required -
What was your favorite item in the walk kit?
(Maximum response 255 chars, approx. 5 rows of text)
9.
Question - Not Required -
What was your least favorite item in the walk kit?
(Maximum response 255 chars, approx. 5 rows of text)
10.
Question - Not Required -
Did you watch the opening ceremonies?
Select
Yes
No
11.
Question - Not Required -
If yes, how did you watch the opening ceremonies?
Facebook
YouTube
12.
Question - Not Required -
Did you hit your fundraising goal?
Select
Yes
No
13.
Question - Not Required -
How can we help you hit your goal before November?
(Maximum response 255 chars, approx. 5 rows of text)
* 14.
Question - Required -
Will you return to the Walk next year?
Select
Yes
No
15.
Question - Not Required -
Would you be interested in post walk fundraising challenges to help us reach the $124,000 goal for patient care, research, and advocacy?
Select
Yes
No
16.
Question - Not Required -
I would like to be more involved next year by:
17.
Question - Not Required -
If you would like to participate on the Walk Committee next year, please provide your phone number or email address
18.
Question - Not Required -
Do you know a company that may be interested in Sponsoring the Walk?
If yes, please provide company name and your contact information below.
(Maximum response 255 chars, approx. 5 rows of text)
19.
Question - Not Required -
Would you be interested in donating a raffle basket for Casino Night in October?
Select
Yes
No
20.
Question - Not Required -
If you answered yes, what is the best number to contact you?
(Maximum response 255 chars, approx. 5 rows of text)
21.
Question - Not Required -
What advice would you give to our Pittsburgh Walk teams who are hosting mini-walk events?
(Maximum response 255 chars, approx. 5 rows of text)