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  2. 2011
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  5. CHAN Sample Survey
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Exit Survey »
 
 
Hello:
You are invited to participate in the Catholic HIV and AIDS Network (CHAN) Member Organization Report. In this survey, approximately 200 organizations will be asked to complete a survey that asks questions to better understand HIV and AIDS relief efforts worldwide and the financing thereunder. It will take approximately 30 minutes to complete the questionnaire.

Your participation in this study is completely voluntary, but important to our research and data analysis. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Fr. Msgr. Robert J. Vitillo by phone or email at the email addresses specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

Rev. Msgr. Robert J. Vitillo
Head of International Delegation in Geneva
Caritas Internationalis
Rue de Varembe 1
CH-1202 Geneva
SWITZERLAND
Tel. +41 22 734 4005 OR +41 22 734 4007 (office)
Tel. +41 79 811 7983 (mobile)
Fax +41 22 734 4006 (fax)
Tel. +39 331 403 6370 (Italian mobile phone)
e-mail: [email protected]
e-mail: [email protected]
 
 
 
* Name of Organisation
   
 
 
 
* Name of Person completing this report
   
 
 
Contact Information for Contact Person
* First Name : 
* Last Name : 
* Address 1 : 
   Address 2 : 
* City : 
* State : 
* Zip : 
* Phone : 
Email Address : 
 
 
 
* During the past fiscal year, approximately what percentage of your organisation's entire budget is dedicated to financial and/or technical support of HIV and AIDS - related projects? (Please indicate in percentage %)
   %
 
 
 
Please give an approximate equivalent of your organisation's overall annual budget in U.S. DOLLARS or in EUROS during the past fiscal year.
US Dollars
Euros
 
 
 
For the following questions, please check which categories of projects you supported during the past fiscal year.

NOTE: If applicable, please also include a list of countries in which you are supporting HIV and AIDS-programmes.
 
 
Please check all that apply:
 
Home Based Care
 
Anti-retroviral Therapy (ARV/ART/HAART)
 
Prevention of Mother-to-Child Transmission (PMTCT)
 
Voluntary Counseling and Testing (VCT)
 
Orphans & Vulnerable Children

 
 
Please check all that apply:
 
HIV Prevention Education
 
Training of Clergy, Religious, Pastoral Agents
 
Training of other Stakeholders (please specify which groups)
 
Lobbying & Advocacy
 
Pastoral Services
 
Tuberculosis and/or Malaria Prevention, Control, and/or Treatment (including an HIV component)
 
Support for and/or Strengthening of Health Care Infrastructure
 
Income-Generating Activities for Persons Living with or affected by HIV (PLHIVs)
 
Other (Please specify)
 

 
 
 
Please describe the work of your organization and your role in that work.
   
 
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