ABOUT YOU AND YOUR INSTITUTION/ORGANIZATION

Please help us respond to your needs, set our agenda for the next five years and bring the benefits of membership to even more contact lens educators worldwide by sparing a few minutes to complete the following survey.
Your help and opinions are important to us. Thank you for your cooperation.
ABOUT YOU

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* 1. Your Name:
Please give us your name in order to enter a prize draw to win an Amazon voucher to the value of US$100. If you would prefer to remain anonymous you may omit your name 

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* 2. Your gender

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* 3. Your age

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* 4. In which IACLE region are you based?

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* 5. What is your discipline? Please select all that apply

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* 6. What are your areas of activity? Please select all that apply

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* 7. And what is your principal area of activity Please select one only

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* 8. What type of institution or organization do you principally work in? Please select one only

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* 9. Who currently pays your IACLE membership fee?

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* 10. Do you require vision correction yourself?

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* 11. And do you wear contact lenses yourself?

ABOUT YOUR INSTITUTION Q12 to Q15 ARE FOR EDUCATOR MEMBERS ONLY. ASSOCIATE MEMBERS GO TO Q16

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* 12. What percentage of your students (third and fourth year) require vision correction?  Please estimate (%)

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* 13. And what percentage of these students wear contact lenses on a regular basis? Please estimate (%)

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* 14. What is the name of your head of school?  Please state

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* 15. Please supply the names of all other contact lens educators in your institution who are not currently IACLE members and might benefit from joining. Please provide email addresses for all those willing to be contacted by IACLE for membership purposes

ABOUT YOUR COMPANY / ORGANIZATION FOR ASSOCIATE MEMBERS ONLY

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* 16. Name of your company / organization:

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* 17. Please supply the names of all other contact lens associates in your company / organization who are not currently IACLE members and might benefit from joining. Please provide email addresses for all those willing to be contacted by IACLE for membership purposes

Thank you for your cooperation 
Please ensure you have given your name and complete both sections in order to enter our prize draw to win an Amazon voucher to the value of US$100. The winner will be notified by email in April

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