This survey was designed with accessibility in mind. For technical assistance, please contact Jennifer Volpe at 617-972-7667 or firstname.lastname@example.org. First Name (required) Last Name (required) Phone Number Email (required) Street Address City State Please select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Zip Code Which Perkins initiative is the most meaningful to you? Please select... Perkins School for the Blind, which helps prepare children of all ages for life beyond the classroom Perkins Library, which delivers books, news, magazines and more in a variety of accessible formats Perkins’ national and international advocacy for the right to education for all blind, deaf-blind and multiply disabled students Perkins eLearning, which teaches professionals and families the latest tools to make education accessible to all students Perkins Solutions, which provides innovative assistive technology products and consulting services Perkins International, which helps under-served children and young adults in 67 countries around the world Other If you selected other, please provide more details Was there a person who inspired your interest in supporting people with blindness or visual impairment? YesNo In a few sentences, please tell us about the person who was influential in shaping your views on the importance of helping people with blindness or visual impairment. Many people engage with Perkins in the following ways. Please select a answer for the following questions: Visiting Campus in Watertown Please select... I already have I would consider I would not consider Using or referring Perkins Library Please select... I already have I would consider I would not consider Volunteering at Perkins Please select... I already have I would consider I would not consider Honoring or memorializing a family member or friend with a tribute giftPlease select... I already have I would consider I would not consider Many people like to leave a gift to charity in their will or trust to support causes that have been meaningful in their lives. Have you left, or would you consider leaving a legacy gift to Perkins? Please select... I have left a gift to Perkins in my will or trust or by beneficiary designation I intend to leave a gift in my will to Perkins I am considering leaving a gift in my will to Perkins I do not think I will leave a gift in my will to Perkins I would like someone to send me more information or contact me about leaving a gift to Perkins in my will Please select... Please mail me additional information Please email me additional information Please call me to discuss further I have enough information at this time Are there other thoughts or comments you’d like to share with us? THANK YOU. We appreciate your taking the time to fill out this survey Need assistance with this form?