Please number (from 1 to 4) the four issues that concern you the most.
Building a stronger economy
Tackling crime in our community
Securing Australia’s borders
Creating local jobs
Removing the carbon tax
Improving health care
Support for local education
Improving and building new roads
Supporting small business
Protecting our local environment
If you could raise one issue in the Federal Parliament, what would it be?
If you could fix one problem in our local area, what would it be?
Please select one of the following options: (optional)
---I always support the Liberal NationalsI always support LaborI always support the GreensI always support PalmerI always support KatterI always support Independent/Other
---I usually support the Liberal NationalsI usually support LaborI usually support the GreensI usually support PalmerI usually support KatterI usually support Independent/Other
---I don’t support any political party
Please complete the following details so that I can keep you informed.
Your Home Phone:
Your Mobile Phone:
How do you prefer to be contacted?: PhoneSMSEmail
Please select the option which best reflects your current situation:
Full-timePart-timeSelf-employedAt home parentUnemployedStudentAge pensionerDisability pensionerSelf-funded retiree