1 Your details 2 Confirm 3 Done Please use Chrome or Firefox as your browser to use this online form. Please note that due to a technical issue, it is not currently working in IE (Internet Explorer). If you require assistance, please contact us on 04 499 0076. Please use this form to order an electronic version of the 2017 IoD Directors’ Fees Report produced with our survey partner EY. A PDF version of the report and an invoice will be emailed to you within two business days from receipt of this form. If you would like a hard copy of the report, please contact EY by email email@example.com Please note EY have a system close down until 16 July and any orders for the 2017 report will be processed slower than usual in this period. If you would prefer to wait until the 2018 report is available, then please email firstname.lastname@example.org and we will ensure you are put on the waitlist. Your details Contact name: * Contact position: * Organisation name: * Contact email: * Confirm contact email: * Contact phone: * IoD membership number (if applicable) Request details Puchasing Options: * IoD member who participated in the 2017 survey - $390 plus GST IoD member who did not participate in the 2017 survey - $590 plus GST Non IoD member who participated in the 2017 survey - $590 plus GST Non IoD member who did not participate in the 2017 survey - $990 plus GST Select this button if you are unsure of which purchasing option is correct for you. We will contact you to confirm. Invoicing Invoice address: * (For IoD purposes only) Name, organisation, address Purchase order number: Terms and conditions Confirm * I confirm I have read and understood the terms and conditions below. I agree that the IoD Directors’ Fees Survey Report is to be used for assessing my/our marketplace levels of directors’ fees and I will not make the report available to anyone outside my company or to any third part. EY Limited and the Institute of Directors will be acknowledged as the source of the survey data. Confidentiality: EY acknowledges the remuneration data provided by participants for inclusion in the IoD Directors’ Fees survey is submitted on a strictly confidential basis. The survey report does not allow particular information to be attributed to an individual organisation.