Your views matter

Please tell me what issues are important to you, locally and nationally, and give your suggestions as to how these issues can be addressed. Your views and details are used only by my office, and are not passed on to any third party.

Please complete this online form below to tell me what issues are important to you. If you would prefer to download an Adobe Acrobat PDF version of the form, to complete by hand and post to me, you can do so here.

Your top priorities
Which of the following local issues are most important to you and your family? Please choose three issues, in order of priority, from the pop-up menus below.
Highest priority
Second highest priority
Third highest priority
Other priorities
Priorities for the future
What should be the Labour government's top priority if re-elected for a third term?

Your support
Which political party do you usually vote for, and which party do you intend to vote for in the forthcoming elections?
Usually vote for
Intend to vote for
Would you be interested in becoming a member of the Labour Party?
	Yes No
About you
Please complete the information below, so that we can get back in touch with you.
First name, surname
E-mail address
Address 1 (as many lines as required)
Address 2
Address 3
Address 4
Post code
Telephone number (day)	code	number
Telephone number (evening)	code	number
	The Labour Party may use these details to contact you in the future. We will not supply these details to any external organisation or individual. Please tick this box if you do not want to be contacted.
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