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FORM 1
FORM 2
FORM 3
FORM 4
Please Enter your Basic details
1.First Name
*
2.Last Name
*
3.Email Address
*
step 1
4.Age
5.Nationality
*
6.Sex
Male
Female
Others
7.Passport No:
8.Qualifications
*
9.Present Position
*
10.Experience
*
11.Official Address
*
12.Home Address
*
13.Mobile No
*
14.WhatsApp No
step 2
15.Fields of interest
*
16.Are you a member of Senadhipan Education Foundation(SEF)?
Yes
No
17.Are you member of any of the following groups of SEF?
Facebook Group
WhatsApp Group
Telegram Group
None
18.Have you been allocated SEF membership no?
Yes
no
19.Approximate number of Minimally Invasive Surgeries done independently till date
Basic
*
Advanced
*
20.Have you ever attended SEF webinars so far?
Yes
no
21.If yes how many?
Select option
<5
6-10
11-15
16-20
>20
22.Approximate screen time of each webinar watched( Percentage of time watched out of total screen time of the webinars)
Select option
<25%
26-50%
51%-75%
>75%
step 3
23.Device name given as your identity while logging in for the webinars:
*
24.Your usual location of logging in for the webinars:
*
25.Are you a subscriber of the YouTube channel of SEF?
Yes
no
26.Do you agree to disseminate your surgical knowledge gained through SEF without financial motives?
Yes
no
27.Do you agree to spread the activities of SEF to benefit a wider spectrum of patients?
Yes
no
28.Do you agree to participate in any survey/ studies /publications initiated by SEF?
Yes
no
29.Your suggestions to improve the activities of SEF:
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