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* 1. Name

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* 2. Contact email

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* 3. Affiliation

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* 4. Where are you based?

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* 5. Will you be attending the launch event on 22nd February at Burlington House?

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* 6. Are you a Fellow of The Geological Society?

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* 7. What is your highest degree?

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* 8. When did you complete your last degree?

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* 9. In what sector of geoscience do you work?

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* 10. What activities and events would you like to see the Network provide?

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* 11. Is there anything you would like to offer to be involved with?

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* 12. How did you hear about the Early Career Network?

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* 13. Are you affiliated with any regional and or specialist groups? If so, which ones?

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