Thank you for taking the time to visit this website. Please note that this survey is for residents of the Hemel Hempstead constituency only, (click here for map).

The information you provide will be used by me to collate and understand the concerns of my constituents.

Please ensure you provide your name, address and email as I may want to contact you about your concerns.

Name:*

Address:*

Postcode:*

email:*

Telephone:

* = Required field

Data Protection Act: The information you supply us with will be treated with the strictest of confidence in accordance with the Data Protection Act. If you do not wish to receive any future information via post or email about Conservative campaigns, please tick this box:

1. Which LOCAL ISSUES concern you most?

1st Priority

2nd

3rd

2. NATIONAL ISSUES - Which three national issues are of greatest concern to you?

1st Priority

2nd

3rd

3. Please raise any other issue you feel is important which you would like to elaborate on.
(if you need more space, you can email me on mike@mikepenning.com).

4. Which party did you vote for in 2005?

Conservative

Labour

Liberal Democrat

Green

UKIP

Other/did not vote

5. If there was a General Election tomorrow, how would you vote?

Conservative

Labour

Liberal Democrat

Green

UKIP

Independent

Will not vote

"Thank you for your time."

For more information about my work in the constituency and in Parliament, please visit my website at: www.mikepenning.com.