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* 1. Surname

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* 2. Forename

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* 3. Gender

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* 4. Where in the UK do you principally practice?

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* 5. Present Grade/Job Title

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* 6. Year of Membership/Fellowship of RCSEd

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* 7. What is your specialty?

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* 8. Do you hold a Certificate of Eligibility for Specialist Registration (CESR)?

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* 9. Do you wish to remain in your current grade throughout your career?

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* 10. What age do you plan to retire?

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* 11. Are you able to access all the training that you feel you need to develop professionally?

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* 12. Any other comments you wish to make?

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