Multiple Sclerosis Limited MS Research

MS Australia empowers researchers to identify ways to treat, prevent and cure multiple sclerosis (MS), seek sustained and systemic policy change via advocacy, and act as the champion for Australia’s community of people affected by MS. But we can’t do it without you! The information we gather from supporters like you enhances and enriches our mutual work and helps bring a louder voice and dynamism to the MS cause.

Step 1 of 12 – Q1

1) Do you believe accelerating Australian research targeting prevention, better treatments and a cure for MS is important?

Yes

I don’t know

2) What is your connection with MS Australia? Please select all that apply

Volunteering at an MS Australia event

Participating in an MS Australia event, such as The May 50K or Kiss Goodbye to 50K

Organising a fundraiser to support MS Australia

Advocating for MS Australia

A family member has multiple sclerosis

Do you have MS (or suspected MS, e.g. clinically isolated syndrome)

A family member or I have benefitted from MS Australia programs and services

Someone close to me has multiple sclerosis

I have a professional connection to MS – for example (a health or allied health professional, or researcher)

Donating

I am a Wire Subscriber

I have taken part in MS clinical trials

I am donating my brain to MS Australia Brain Bank after my lifetime

Reading the website and/or following on social media

I am a unpaid carer for someone with MS

I am a paid carer of someone with MS

Other

2a) Other – Please specify:

Please specify:

2b) How frequently do you engage with MS Australia?

How frequently do you engage with MS Australia?

Weekly

Monthly

Every few months

Yearly

Rarely or never

Other

2b-i) Other – Please specify:

Please specify:

3) We like to send supporters like you occasional emails with updates including videos, stories, and information about how we are making an impact on your behalf. Would you like to receive these updates? (You can opt-out at any time).

Yes, I want to receive occasional emails with updates.

Not at this time.

4) Which aspect of MS Australia's work is most meaningful to you?

Research

Advocacy

Education, Communication and Awareness

Providing for our MS state organisations so they can provide support services

International Collaboration

5) Was there an influential person in your life who inspired your appreciation of MS Australia?

Yes

5a) If yes, please indicate their relationship to you.

If yes, please indicate their relationship to you.

Parent/grandparent

Spouse/partner/significant other

Child/children

Family member

Friend

Neighbour or community member

Health professional

Other

5a-i) Other – Please specify:

Please specify:

6) Do you think MS Australia’s strategy should focus on MS research, advocacy for MS and the provision of evidence-based information and resources?

Of utmost importance

Very important

Somewhat important

Not very important

Not important at all

7) Supporters of MS Australia recognise how important it is to fund and progress vital MS research and advocacy. Would you consider furthering our work in any of the following ways?

I already have	I am likely	I am somewhat likely	I am not likely

Donating online with a credit card

I already have

I am likely

I am somewhat likely

I am not likely

Mailing a cheque

I already have

I am likely

I am somewhat likely

I am not likely

Talking with a Relationship Manager one-on-one about making a substantial impact

I already have

I am likely

I am somewhat likely

I am not likely

Making a regular contribution

I already have

I am likely

I am somewhat likely

I am not likely

Giving appreciated assets (such as personal or business stocks or bonds, land or rental real estate, etc.)

I already have

I am likely

I am somewhat likely

I am not likely

Volunteering

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Private Ancillary Fund

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Family/Trust Foundation

I already have

I am likely

I am somewhat likely

I am not likely

Giving property (such as jewellery, artwork, or other assets)

I already have

I am likely

I am somewhat likely

I am not likely

Organising a Kiss Goodbye to MS Event

I already have

I am likely

I am somewhat likely

I am not likely

Would you consider a special gift of $1,000 or more to a special campaign we need funding for within the next 6 months?

I already have

I am likely

I am somewhat likely

I am not likely

8) Many people like to include gifts to charity in their Will to support causes that are important in their life. Would you consider making such a gift to MS Australia to help find ways to prevent and cure MS?

I have included a gift for MS Australia in my Will, Trust or by Beneficiary Nomination.

I am interested in making this type of gift to MS Australia.

Not now, but in the future I would definitely be interested in making this type of gift to MS Australia.

Not now, but in the future I might possibly be interested in making this type of gift to MS Australia.

I am not interested in this type of gift.

8a) Please tell us about your legacy gift:

Please tell us about your legacy gift:

I planned this gift in honour or in memory of someone.

I would like this gift to go to a specific program or purpose.

MS Australia may use this gift where it is needed most.

8a-i) Please provide the name of and/or association with this person:

Please provide the name of and/or association with this person:

8a-ii) Please describe the intended program or purpose:

Please describe the intended program or purpose:

Guides

Please send me more information to help with my decision.

9) How does MS Australia rank in comparison to other organisations or charities you may support?

My top choice for charitable giving

Near the top of my list

Middle of my list

Bottom of my list

Not on my list

9a) Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of MS Australia?

Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of MS Australia?

Yes

9a-i) Please let us know the most convenient way to connect:

Please let us know the most convenient way to connect:

I would like to introduce the person(s) to MS Australia on my own.

I would like MS Australia to provide me with resources to share with the person(s).

10) Is there anything else you would like to share with us? Perhaps you have a story about why our work is important to you.

11) About You (optional)

Age

Under 40

40 – 49

50 – 59

60 – 69

70 – 79

80 – 89

90+

Gender

Male

Female

Other/Nonbinary

Prefer not to specify

Please specify:

What is your marital status?

Married

De facto

Not married

Divorced

Widowed

Which of the following best describes your family?

No children

One child

Two or more children

Please tell us the highest level of education you completed:

High school graduate or equivalent

Some college/higher education

Technical Certificate/Diploma

Associate’s degree

Bachelor’s degree

Doctoral degree

Please select the option(s) that best describes your professional life.

Working full time

Working part time

Retiring within 5 years

Retired

Volunteering

Business owner

Self-employed

Other

Profession:

Please check the box below if you would like to update your contact information.

I would like to update my contact information.

First name(Required)

Last name(Required)

Address

Address 2

City

State

Postcode

Country

Phone

Email(Required)

Hidden

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