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* 1. Thank you for completing this survey to provide evidence for the Campaigning Alliance for Lifelong Learning (CALL). Details of the campaign can be found online at http://www.callcampaign.org.uk. This survey will be available until 9 January 2009.

Please complete the following personal details, so that the evidence can be shown to be genuine. No personal details that identify you will be shared beyond CALL without your permission.

* 2. We are collecting positive stories about how lifelong learning has affected adult learners. Have you ever taken part in lifelong/ adult education?

* 3. Have you been affected by cuts in adult learning as fewer courses are available?

* 4. Have fee increases stopped you taking part as fully in adult learning as you want to?

* 5. Please let us know about any other factors that stop you from taking part in adult education courses.

* 6. It would help to build up a picture of which groups are affected if you could tick as many boxes below that apply to you. (This is entirely optional and will not be shared publicly other than as an anonymous part of our statistics)

* 7. It would help us to know your HIGHEST level of qualification.(Again, this is entirely optional and will not be shared publicly other than as an anonymous part of our statistics)

* 8. Please feel free to add any further comments below.

* 9. Are you happy for your story to be used in CALL campaigning?

* 10. Many thanks for completing this survey.

When you click 'Done' in the grey box below your survey will be submitted automatically to CALL. Please print the completed survey at this stage if you wish to keep a copy of your answers.

Please let as many people as possible know about CALL and encourage them to join us.

Finally please let us know the email address of anyone else who might be willing to complete this survey or join the campaign.

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