Aansoek om registrasie
Application for registration


Naam van departement /Buro / Instituut / Sentrum / Geregistreerde organisasie
Name of Department / Bureau / Institute / Centre / Registered organisation
Survey Naam/Survey name

Verlang u dat meer as een persoon die survey kan opstel?
Do you want more than one person to have access to the design of the survey?
Yes No
Aktief vanaf /First date active                     (yyyy/mm/dd)
Laaste datum aktief/Last date active        (yyyy/mm/dd)
Beoogde aantal response/ Aimed number of responses
Interne / Eksterne respondente
Internal / External respondents

Indien u respondente intern of beide ekstern en intern is, het u reeds goedkeuring ontvang om die opname te doen?
If your respondents are internal or both internal and external, have you obtained permission to conduct the survey?

Stel u belang om 'n opleidingsessie by te woon?
Are you interested in attending a training session?
Yes No
Gee asseblief 'n kort beskrywing van die opname
Please give a short description of the survey
Hoofdoel van die opname
Main aim of survey
Studieleier
Study Leader
Studieleier/Study leader
Studieleier epos/Study leader email
Kontakpersoon
Contact Person
Titel/ Title
Naam/First Name
Van/Last Name
US nommer/US Number
US gebruikersnaam/US user name
Eposadres/E-mail address
Telefoon/Telephone
Selfoon/Cell phone
Faks/Fax