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eQIPd Order Form

Contact

1. Contact Information *This question is required.

First Name

Last Name

Organisation

Email Address This question requires a valid email address.

Town/Suburb

2. Who would you like to survey? (please select all that apply)

Families
Staff
Children
Committee

I would like to purchase:

Parent Survey ($195 plus GST) - the Basic Survey customised to your service with Benchmarking included in your reports
Option to add three tailored questions ($55)
Parent End of Year Survey ($195 plus GST) - NQF and EYLF questions
A fully customised survey - I would like eQIPd to provide a quote
The Premium Package - parent, staff and committee surveys, benchmarking ($410 plus GST)

I would like to purchase:

Staff Survey ($195) - the Basic Staff Survey customised to your service with benchmarking included in the reports.
Extra Tailored Questions ($55)
A fully customised survey - I would like eQIPd to provide a quote

I would like to purchase:

3. What type of service do you want to survey?

As part of the Premium Package, we can produce reports by room so that your educators hear from the families of children in their group.
If you would like this, please tell us the names of your groups/rooms below.

Group 1:
Group 2:
Group 3:
Group 4:
Group 5:
Group 6:

When would you like to send your survey out?

This question requires a valid date format of DD/MM/YYYY.

calendar

When would you like your survey to be closed? (we recommend keeping your survey open for 2 to 4 weeks. You can get your reports within a week of closing the survey.)

This question requires a valid date format of DD/MM/YYYY.

calendar

If you know what extra questions you would like to ask as part of your survey, please record them below.

6. Any other comments/questions?