* 1. Age

* 2. Gender

* 3. Organisation name

* 4. Relationship with CIVICUS (Choose all that apply.)

* 5. Our new Strategic Plan details how we want to make a difference and with whom. In your opinion, for us to make a difference in 2017/2018 which of these stakeholders should we have as a key focus for this period? (Please select in order of the most relevance for you, 1 being the most important.)

* 6. In pursuit of our 3 new strategic priorities and CIVICUS’ mission of strengthening citizen action and civil society, we commit to the below listed actions. Which of these new ways of working best resonate with you? (Please select up to 3 options if possible.)

* 7. Tell us how you think we can work together to make a difference.

* 8. Do you think our current membership policy (verified fee-based voting category, and minimally checked free associate category) still makes sense in the current civil society landscape, world reality and our new Strategic Plan?

* 9. What are the criteria CIVICUS Secretariat should be using at the moment of evaluating a member's accountability, commitment and engagement to the alliance's mission of strengthening civil society?

* 10. If you would like to discuss the Strategic Plan in more depth, and how the alliance can effectively implement it, you can leave your contact details below and we will contact you by email for a skype meeting or call. We welcome all comments, ideas, thoughts and other input through all communication means.

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