Voting Intention Survey
www.wyreforestlabour.co.uk
If you live in the Constituency of Wyre Forest,
you are welcome to complete our Online voting survey.
Please complete the form below and click on the send button.
Select Party
Labour
Conservative
Liberal Democrat
Independent
Health Concern
Undecided
Other
Who will you
support at the next General Election?
Select GE Choice
Labour
Conservative
Liberal Democrat
Didn't vote
Other
How did you
vote at the last General Election?
Select 2nd Choice
Labour
Conservative
Liberal Democrat
Independent
Health Concern
Other
Which party
would be your 2nd choice?
No
Yes
Do you
vote at every election?
Select Age range
Under 18
18 to 25
26 to 40
41 to 60
Over 60
Prefer not to say
Your
age group?
gender
Male
Female
Are you
male or female?
select
Yes
No
Would
you like to help Labour?
select
Yes
No
Display Poster
at Election times?
select
Yes
No
Please
send me Information about joining the Labour Party?
select
Yes
No
Would
you like to make a donation?
Forename
Surname
Email
Postal
Address
Telephone
Comments
Thank you for
taking the time to complete our survey