Community Survey

The Issues (Please number the four issues that concern you most.)

In Parliament (If you could raise one issue in the Federal Parliament, what would it be?)

Our Community (If you could fix one problem in our local area, what would it be?)

About Politics (Optional) (Please select one of the following options)

Your Details (Please complete the following details so that I can stay in touch and keep you informed.)

Your Work (Please select the option that reflects your current situation)