Firstly, are there any local issues or concerns that you would like me to tackle or raise with the Council?
Check any that apply
Which THREE of the following issues are most important for you and your family? Tick up to 3 boxes
Check any that apply
To make the survey results representative, could I ask you how you voted in the 2015 General Election?
Check any that apply
Thinking ahead to the next General Election, as things stand today, what are the chances of you voting for each of the following parties – on a scale of 0-10 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
Lib Dem
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? 

Choose one of the following answers
Would you be willing to display a poster at election time?
Choose one of the following answers
About you: