Leaver Questionnaire

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Leavers Questionnaire

We really value your support and are sorry that you are leaving us

We are continually trying to improve what we do and would really appreciate if you could just take a few minutes to fill out this questionnaire and submit it to us. All responses are confidential and will only be used for research purposes. Fields marked with a * must be completed.
(this is your reference number beginning with 'S' on the email we sent you)

If you are completing this form on behalf of someone else, please provide your contact details:

Please put 'N/A' if not applicable
Please put 'N/A' if not applicable
Was there a particular reason you cancelled?
(Max Characters 400)
Is there anything that we could have done to encourage you to stay?
(Max Characters 400)
Do you feel we kept you informed on how your support helped:
How likely would you be to consider re-joining in the future?
Where 1 is very dissatisfied, and 5 is very satisfied)
(Max Characters 400)

Supporting us in the future

We recognise that you may have been reluctantly forced to cancel your subscription for financial reasons. If you would like to discuss a subscription payment holiday rather than cancelling your subscription completely, please complete the sections in either Option 1 or Option 2 below.

Option 1 – Subscription payment holiday

This is an option to suspend payments to us for a specified period of time. If you usually pay by Direct Debit this will automatically re-start on a date of your choice. Re-instated plays will be in line with the amount and frequency of your previous subscription.
1) I would like a subscription payment holiday:
2) I would like my subscription/s to renew in:
Please select how you would like to pay

Option 2 - Re-join at a future date

1) I would like to re-join at a future date:
2) I would like to discuss this with a member of The Hospice Lottery staff and would like them to contact me by:

Privacy Statement

The Hospice Lottery Partnership will store and process information about you for the purpose of providing services in accordance with our charitable aims. Using your consents as listed above, or in the event of a legitimate business requirement we will contact you from time to time using your preferred contact method(s). You have the right to review details of your personal data that we hold or to amend or cancel both your consent and preferred method(s) of contact by advising us on 01442 891459 or info@hospicelottery.org.uk. Your data will not be shared with any third party unless we have your consent to do so or in the event of regulatory requirement. We may transfer your data to organisations outside the United Kingdom in compliance with the conditions of transfer set out in the Data Protection Act (2018).
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Contact us

01442 891459
info@hospicelottery.org.uk

The Hospice Lottery Partnership Ltd
72-80 Akeman Street
Tring
Hertfordshire
HP23 6AF

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© 2021 The Hospice Lottery Partnership Limited

Registered in England No. 03458520. The Hospice Lottery Partnership Ltd is licensed and regulated in Great Britain by The Gambling Commission (gamblingcommission.gov.uk) under account number 5060.

Promoter: The Hospice Lottery Partnership Limited, 72-80 Akeman Street, Tring, Hertfordshire, HP23 6AF. T: 01442 891459. Responsible person: Belinda Ellis. If you or someone you know needs information or help with a gambling problem, please call us on 01442 891459 or you may wish to visit begambleaware.org