Get in touch with Hina & The Team Here

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Fill in your contact details below and a member of the team will be in touch shortly.

* Indicates required question

Email *

Your email

First Name *

Your answer

Last Name *

Your answer

Email *

Your answer

Local Party *

Your answer

Phone number

Your answer

Comments *

Your answer

Would you like to be kept up to date about Hina's reselection campaign? *

Yes, please

No, thank you

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

This form was created inside of Hina Bokhari .

Help and feedback