* 1. Surname

* 2. Forename

* 3. Gender

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

* 5. Present Grade/Job Title

* 6. Year of Membership/Fellowship of RCSEd

* 7. What is your specialty?

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

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

* 10. What age do you plan to retire?

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

* 12. Any other comments you wish to make?

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