GivePulse Interest Form

Thanks for your interest in GivePulse. Please fill out this brief form so that we can help you or your organization get started with GivePulse. Thie information will enable us to set up a base GivePulse page that can be edited and managed independently. Additional collaborators can be added later.

First Name

Last Name

Email Address

Please provide the best email to contact you.

Iowa State Affiliation?

Are you affiliated with ISU as either a faculty, staff or student? Your response (Y/N) will help us capture the information needed to set up your GivePulse page.

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College Affiliation

Please enter the general affiliation you or your organization have with the University. Leave blank if there is no direct affiliation.

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Campus Role

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Faculty GivePulse Needs

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Course Number and Name

Name of Lab or Project

Name of Outreach Project

Name of Event

Other Need (Please Describe)

Staff GivePulse Needs

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Student GivePulse Needs

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Name of Student Organization

Name of Fraternity or Sorority

Name of Student Event

Other Student Need (Please Describe)

Description for Campus GivePulse Page

Community Role

Are you affiliated with a Story County community organization or non-profit group ?

Community Organization

Name of Story County Organization

Description for Story County GivePulse Page

Please provide a short description that could be used to set up your page (This can be edited later).

County or Regional Affiliation

Are you interested in establishing a state, county or community-level page for GivePulse? If so, please indicate if you are affiliated with your county health or county extension office.

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County Affiliation

Please enter the name of the county you most directly serve. If you aren't affiliated with a specific county, please leave it blank and you will be able to provide more information about your needs.

Name of Organization

Please provide the official name of the organization or group you are affiliated with (This name will be used to set up your GivePulse page).

Description for Organization GivePulse Page

Please provide a short description that could be used to set up your page (This can be edited later).

GivePulse Functions

What is the primary purpose of GivePulse for your organization. If there are multiple needs, select 'multiple needs' as the best option.

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GivePulse Support?

GivePulse provides resources and tips to get started, but members of the campus GivePulse team may be able to provide some help. Would you like to receive additional support in setting up your GivePulse page?

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Give Pulse User Group?

Would you like to be connected to a virtual 'user group' that would allow for sharing of tips over time and connections with other local GivePulse users?

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Send me a copy of my responses

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