Donor Impact Report Intake Form

Help Us Thank Your Supporters

As this year ends, we are beginning the process of preparing a Stewardship Report for the donor(s) of the endowed fund, for which your area is a beneficiary. As good stewards of the gifts donors have given to Connecticut Children’s, we promise to provide annual updates to demonstrate the impact of their generosity, as well as an update of audited financials for endowed accounts.

Please complete the following by October 4, 2024, so we can use this information to create a FY24 Impact Report for the donor(s).

Intake Form Tips

You may cut & paste into the fields below, type your responses as full sentences or provide a bulleted list of highlights.
Please attach any photos (jpgs) or publications (PDFs) you would like the Stewardship & Donor Relations Team to use as source material for the Impact Report.

First Name of person completing this form ^*

Last Name of person completing this form ^*

Name of Fund ^*

Describe specific expenditures from the Fund this past year. If you did not spend from the Fund this past year, please describe future expenditures you plan to make. (It’s okay to “save up” for a larger expenditure, but we should explain this to the donor.) ^*

In 3 -5 sentences, describe the impact the Fund had this past year on patients, families, research advances or programs offered. ^*

Please provide a quote that expresses your gratitude. Rather than simply “thank you for giving” consider a cause-and-effect quote that highlights the donor, like “Because you made a generous investment, my team and I were able to enroll 17 children in clinical trials and give 17 families more hope than they would have had otherwise. We are incredibly grateful for these resources, so thank you!” ^*

Document File(s)

Unlimited number of files can be uploaded to this field.
256 MB limit.
Allowed types: pdf, doc, docx, ppt, pptx, xls, xlsx.

Image File(s)

Unlimited number of files can be uploaded to this field.
256 MB limit.
Allowed types: gif, jpg, jpeg, png.