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* 1. As you may know, each year UIA conducts several study missions to Israel.  We are considering running "special interest" missions, commencing in 2018 with health professionals, and are interested in your views.

Are you a health professional?

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* 2. Apart from health, what areas or activities might interest you enough to participate in a future UIA study mission. (You can tick more than one answer).

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* 3. I am a:

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* 4. Which of the following would you like to see included in a medical mission? Note there is no guarantee that a particular choice will be available. (You may tick more than 1 answer).

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* 5. The 2018 UIA Medical Mission is tentatively planned to commence on Thursday April 12 (Yom Hashoah) and will conclude on Wednesday April 18, which is Yom Ha'atzmaut and in 2018 is the 70th anniversary of the founding of the State of Israel, so this will be an exciting time to be there. Pesach is March 31 -  April 7, 2018 which gives participants the choice to spend Pesach in Israel prior to the mission, or come to Israel after Pesach.  Without obligation, please indicate your interest in participating in this mission.

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* 6. Depending on demand, we haven't planned for young children at this stage, but there will be a partner's program available. If participating, will you be accompanied by: (more than 1 answer permissible)

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* 7. Have you participated in a study mission previously?

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* 8. Which year would better suit you for a UIA Medical Mission (assuming it is to take place in March/April)?

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* 9. Please provide your details below, so that we may contact you should the mission go ahead, thank you.

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