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Name?

Home Address (And Postcode):
Telephone Number:

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On a scale of 0-10, where 0 is very unsafe and 10 is very safe, how safe do you feel in your community?
  1 2 3 4 5 6 7 8 9 10
0 is very unsafe, 10 is very safe
If Cleveland Police were to review their use of speed cameras, what would you prefer to see?
Choose one of the following answers
How often would you say you see a Policeman on the beat in your community?
Choose one of the following answers
Which THREE of the following issues do you think are most important for your Police and Crime Commissioner?
Check between 3 and 3 answers
Which TWO of these commitments, made by David Cameron and the Conservatives, are the most important to you?
Check any that apply

How did you vote in the 2015 General Election?

Check any that apply
Thinking about the Police Comissioner elections in May, how likely are you to vote in this election - on a scale of 0-10, where 0 means absolutely no chance of you voting and 10 means you are absolutely certain you will be voting?
  1 2 3 4 5 6 7 8 9 10
0 means absolutely no chance of you voting and 10 means absolutely certain you will be voting?
Thinking ahead to the PCC Election, as things stand today, what are the chances of you voting for each of the following parties - on a scale of 1-10 where 0 means there would be no chance of you voting for the party and 10 means you would be absolutely certain to vote for the party?
  1 2 3 4 5 6 7 8 9 10
Conservative
Liberal Democrat
Labour
UKIP
Green
Independent
Other
Many people find it easier to vote by post, guaranteeing their vote even if they are away or ill. Would you like an application to vote by post?
Check any that apply
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