Application for ASGBI Survey Support
For: Research teams requesting ASGBI support in sharing their survey to its membership
Section 1: Project Details
1. Survey title
*
2. Name of lead researcher
*
3. ASGBI members involved in research team (2 names required)
*
4. Email address
*
example@example.com
5. X (Twitter) handle (study or personal, if appropriate)
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Section 2: Survey Information
6. Link to survey
7. Desired respondent group (e.g. consultants, registrars):
*
8. Start date of study
*
-
Day
-
Month
Year
Date
8. End date of study
*
-
Day
-
Month
Year
Date
9. Has the survey undergone pilot testing?
*
Yes
No
Not applicable
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Section 3: Additional Comments and Declaration
10. Use this section to provide extra information you think is important or to request any additional support
11. Tick to acknowledge the following
*
I confirm that the information provided is accurate and complete
Submit
Should be Empty: