Community Survey
Your opinions and concerns are important to me, please take a minute to fill out my survey.
Your Views
The three things that matter most to me are:
If I could fix one national problem it would be...
Your answer
If I could fix one local problem it would be...
Your answer
An issue/suggestion I have is...
Your answer
I usually vote (optional):
Your Details
Name
Your answer
Mobile/Phone
Your answer
Email
Your answer
Address
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Australian Labor Party.