Local Residents' Survey
Please complete the survey questions below to have your say and help us represent the views of all local residents. Please tick all boxes that apply unless indicated otherwise.
Over the past ten years or so do you think the NHS has?
Please choose one
Do you support Conservative proposals to cut borrowing by?
Please tick all that apply
Your priorities. Which of these do you want your MP to focus on?
Please select 1, 2 and 3 from the drop-down menu in order of priority
1.
2.
3.
If you selected 'Other', please enter more details below:
What change would you like to see in the local NHS?
Please enter text in the box below
Where would you most like to see increased police patrols?
Please enter text in the box below
About You
We want to make sure we are working on behalf of everyone - so to help us to get a balanced representation of local views, please complete this section.
What is your age group?
Please choose one
Which party are you likely to vote for at the upcoming general election?
Please choose one
Thank you for taking the time to complete this survey. We would like to keep in touch with you about issues you have raised. If you would be happy for us to do this by email and mobile phone, please complete your details below:
Name
If you selected 'Other' as a priority, please enter more details below:
Address
Phone*
Email*
Data Protection Information
By submitting this form, you are agreeing to receive communications and information from us. We will not pass your personal details to third-parties without your explicit consent.
Please note: under the Data Protection Act 1998, returning this form acknowledges that you consent to the information being held on the conservatives.com database. We will only use this information for our own purposes.
*By giving us your email address and/or mobile number, you are agreeing to receive communications and information from us by email and/or SMS. If you are registered for the Telephone Prefernce Service, by giving us your home number you are giving us permission to ignore this and occasionally call you
Promoted by D Coomber on behalf of Mark Reckless all at 200 Canterbury Street, Gillingham, ME7 5XG
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Mark Reckless is the Conservative Prospective Parliamentary Candidate (PPC) for Rochester and Strood and will be standing for MP at the next General Election
