Send out the GLWS GLWS Survey Administration Request Use the form below to request a GLWS survey to be sent to one or more respondents. "*" indicates required fields GLWS Subscription Plan StatusSubscription Plan Status* This request is part of a GLWS Subscription Plan already purchased. I/my organisation does not have a current GLWS Subscription Plan and I/we would like to purchase one. Subscription Plan purchased*Click to drop down for optionsIndividual Starter Pack: 10 GLWS (min. upload =1)Organisation Starter Pack: 15 or 40 GLWS (min. upload = 5)Subscription Plan 5 or 10 (min. upload =1)Subscription Plan 5 or 10 (min. upload =1) with pre-purchased GLWS MyWellbeingSubscription Plan 40 (min. upload = 5)Subscription Plan 40 (min. upload = 5) with pre-purchased GLWSMyWellbeingSubscription Plan 100 (min. upload = 10)Subscription Plan 100 (min. upload = 10) with pre-purchased GLWS MyWellbeingSubscription Plan 200 (min. upload = 10)Subscription Plan 200 (min. upload = 10) with pre-purchased GLWS MyWellbeingSubscription Plan 400 or 1000 (min. upload = 10) GLWS MyWellbeing includedUnsure - please email support@glwswellbeing.comTo avoid additional administration fees, this is a gentle reminder to ensure the Survey Administration Request you are about to complete meets or exceeds the minimum number of surveys that are required to be uploaded at any one time as part of your Subscription Plan deal. The minimum number will be 1, 5 or 10 depending on which Subscription Plan you are using, as shown in the drop-down list above. If you cannot meet the minimum, we will still be able to send out the exact number of surveys you have requested but an extra fee of $55+GST per upload order will apply. A pre-purchased GLWS Subscription Plan is required before you can submit a request for GLWS administration. Please click here to purchase a GLWS Subscription Plan. Thank you! GLWS Accredited Practitioner / Program Manager DetailsPleaseprovide contact details for the GLWS Accredited Practitioner or person responsible for this survey administration request. We will contact this person if we have any queries, and we will use this information to match and track the subscription plan with the number of surveys requested.First name of GLWS Accredited Practitioner / Person Responsible*Last name*Email* Organisation*Phone number* IT SecurityAs organisations continue to strengthen their IT and cyber-security protocols, Most legitimate GLWS emails with links to the GLWS Survey or with attachments to GLWS Reports can be inadvertently blocked or rejected by the receiving organisation(s). To avoid this happening to your survey links or reports, communicate the following information to the Accredited Practitioner’s and Survey Respondents IT departments and confirm they have updated their IT Security protocols:Please indicate which data centre you would like your GLWS Respondent's data to be processed.*CountryAustralia Data CentreUnited Kingdom Data CentreNote: A separate request form is required for each data centre.IMPORTANT NOTE: Some organisations have IT security settings that may block the survey from being received. Please ask your respondents to request the following domains be whitelisted: IP ranges: 64.69.212.0/24, 98.97.248.0/21 and 139.60.152.0/22; Domains: glwsolutions.qualtrics.com and _.qualtrics.com/_ ; Email addresses: noreply@qemailserver.com (to enable deliver of the survey link) and glwsadmin@glwswellbeing.onmicrosoft.com (to enable delivery of the survey response report). IMPORTANT NOTE: Some organisations have IT security settings that may block the survey from being received. Please ask your respondents to request the following domains be whitelisted: IP ranges: 98.97.248.0/21 and 139.60.152.0/22; Domains: glwswell.qualtrics.com and _.qualtrics.com/_ ; Email addresses: noreply@qemailserver.com (to enable deliver of the survey link) and glwsadmin@glwswellbeing.onmicrosoft.com (to enable delivery of the survey response report). Respondent and invitation set up informationPlease provide details for the people you would like us to send a survey link and invitation to on your behalf. We’re sorry but we are unable to check the spelling of any of the details provided. So, please take a moment to double check the accuracy of these details. This will reduce delays and/or additional fees which may occur should we need to resend or amend any part of the set up. Thank you!GLWS Respondent's Organisation*Project NameEnter a project name to include the respondent(s) in a group (required to have the option of a group report now or in the future).How many respondents would you like to invite to complete the GLWS?* One More than one GLWS Respondent's first name*GLWS Respondent's last name*GLWS Respondent's email* Please download our .csv template, fill it out for each respondent and upload below. Notes: The minimum is First Name, Last Name, Email address. You can enter up to 2 email addresses for report receipt, please separate using ";". Please take a moment to double check the accuracy of the information you've provided to avoid delays and additional fees which we may charge for resending or amending surveys already administered (e.g. email bounce due to incorrect email address)File*Accepted file types: xlsx, csv, Max. file size: 10 MB.Please provide the key dates for your GLWS survey administration. We typically only send one reminder per request, however should you require more than one reminder, please let us know the dates for the subsequent reminders. There is no charge for this if you provide this information to us now. However, we will charge AUD$55 per subsequent reminder request if you do this after the survey has been sent out. Date for GLWS to be sent*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date for reminder to respondentsDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920This is optional, however we do recommend 1 week prior to completion date if you are considering requesting reminders to be sent.Deadline for GLWS to be completed*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920We recommend 2 weeks from the date that the survey is sent. Please keep in mind that GLWS MyWellbeing access (where purchased) expires at 6 months from the date that the GLWS is sent. GLWS respondents will only receive their login details upon completion of the GLWS. Additional reminder dates (please use dd/mm/yyyy format)We typically only send one reminder per request, however should you require more than one reminder, please enter the subsequent reminder dates in the box above. There is no charge for this if you submit this information now along with the rest of the survey administration information. However, we will charge you AUD$55 per reminder request after this survey administration request has been submitted. Please leave the above box blank if additional reminder dates are not required. Depending upon the objectives, timeframes, confidentiality expectations and context for deploying the GLWS Survey, the Accredited Practitioner/Program Manager must choose an approach for distributing the GLWS Personal Reports. For each upload request, reports may be sent to only ONE person (the Accredited Practitioner or the Program Manager or the Survey Respondent), or as required, may be sent to a maximum of TWO people’s email addresses (any combination of Accredited Practitioner, Program Manager or Respondent). Please separate email addresses using a semi-colon (;)Report delivery email(s)*Please provide the email address(es) for the delivery of the Personal Report. You can send the report to a maximum of 2 recipients. Please separate emails using a semi-colon (;) First and last name(s) of report recipients*Our working week is from Monday-Thursday in Australia. Surveys are only set up and sent out on these days. They may be completed by Respondents on any day. For surveys to be sent out on Friday Australian time, please submit your order by 4pm AEST on the Thursday prior. Alternatively, we welcome advance requests and can schedule survey invitation delivery accordingly. GLWS MyWellbeingGLWS MyWellbeing is is our online portal dedicated to providing GLWS Survey Respondents with high quality self-directed guidance and resources to assist them with their GLWS report interpretation, and to provide ongoing accessible support over 6 months that targets their identified wellbeing challenges. It is a powerful educational and personal development solution.Would you like to include access to GLWS MyWellbeing for the Survey Respondents in this request?* Yes. I have already pre-purchased access to GLWS MyWellbeing included as part of my GLWS Subscription Plan. Please set up the Survey Respondents included in this request with access to GLWS MyWellbeing. Yes. I would like to add-on this option for all Survey Respondents in this request, and will purchase this after I submit this request form. I understand that my GLWS surveys will not be sent out until payment for this has been made. No, I do not want to give the Survey Respondents included in this request with access to the GLWS MyWellbeing self-development portal and understand that I will be unable to add this after this request has been submitted. To avoid unnecessary delay in your GLWS survey administration, please purchase the same number of GLWS MyWellbeing units as the number of GLWS surveys requested. We're sorry that we cannot do partial GLWS MyWellbeing purchases nor allow the GLWS MyWellbeing units purchased be ‘stored’ for future use. Please click here to purchase the GLWS MyWellbeing access as an add-on for your GLWS Respondents. Thank you!Note: The GLWS MyWellbeing login information for each respondent will be provided in the same email that delivers their GLWS Personal Report. If the report delivery is not going directly to the respondent in the first instance, the onus is on the Accredited Practitioner or Program Manager to communicate this to the respondent at a time of their choosing. The easiest way to do this is to forward the report delivery email to the respondent at the appropriate time for their debrief. . Just a final (gentle!) reminder that MyWellbeing is only available to add on if pre-purchased as part of a GLWS Subscription Plan or requested at the time of a survey administration request (i.e. this form). You will not be able to add MyWellbeing on after this survey administratin request has been submitted. Other comments / instructions ConsentConsent* By submitting this form, I confirm that I have read and agree to the statements below:1. I consent to sharing the Survey Respondent(/s’ personal data (name and email address) with EEK & SENSE for the purpose of administering the GLWS. 2. I understand and accept I am responsible for ensuring the accuracy of the Survey Respondent/s’ personal data provided to EEK & SENSE.. 2. I consent to paying an additional administration fee of AUD$55 if the number of GLWS surveys I request in this order does not meet the minimum upload requirements for my GLWS Subscription Plan size. 3. I consent that the number of GLWS surveys and GLWS MyWellbeing allocation (where applicable) will be deducted from my purchased GLWS Subscription Plan upon administration, regardless of the Survey Respondent completion/usage status. 4. Where GLWS MyWellbeing has not already been pre-purchased as part of a subscription, I consent to paying an additional $AUD180 (international rates varies and confirmed at purchase page) for each respondent in this request form to be provided with ad-hoc access to GLWS MyWellbeing for a period of up to 6 months from the survey send date. 5. I understand and agree that the GLWS Personal Report will only be sent by EEK & SENSE to the email addresses I have nominated above, and that I am responsible for the distribution of these reports to the respondent if they are not included as one of the email addresses I have nominated. IMPORTANT One unit of survey, personal report and GLWS MyWellbeing (where pre-purchased) will be deducted from the remaining quantity available from Subscription Plan when a survey link is created. This means that irrespective of whether the survey link is subsequently opened or completed, or GLWS MyWellbeing (where pre-purchased) is selected, one unit of GLWS Survey, report and GLWS MyWellbeing (where pre-purchased) will be considered to have been 'consumed'. A new page will appear to confirm that your form has been successfully submitted. If this does not appear, we have a problem! It means your order has not been submitted. Please scroll up to view any errors and give it another go! You will have to click ‘Submit’ again. Thanks for persevering.