30 second survey

30 Second Survey Form

Your Name(Required)
As appears on the electoral roll
Address
If you could raise one issue in Federal Parliament, what would it be?
If you could fix one problem in your local community, what would it be?
The Issues:
Please tick the four issues that concern you most
Your Politics:
Please select one of the following options: (optional) I ALWAYS support the following Party
Your Politics:
or I USUALLY support the following Party
Your Situation:
Please tick the boxes that most align with you. Feel free to tick as many boxes that suit.

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