* 1. Your Name and Post Code:

* 2. Your e-mail address:

* 3. How would you describe our Area?

* 4. Please tell us other things you would like to see improved locally (potholes, litter or unsafe areas)

* 5. Thinking about our area, what 3 issues concern you and your family most?

* 6. The Liberal Democrats are campaigning to double the number of businesses that take on apprentices. Do you support this campaign?

* 7. What single measure could the Government take to help you and your family with the cost of living?

* 8. Do you support the Lib Dems Income Tax cuts that will save ordinary workers £700 a year and take many low earners out of tax altogether?

* 9. On a scale of 1 (lowest) to 5 (highest), how well do the parties speak up for you?

  1 2 3 4 5
Conservative
Labour
Liberal Democrat
UKIP
Other

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