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COMMIT YOUR VOTE
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Complaining about the Government will achieve absolutely nothing.
While marches, public meetings and demonstrations take place,
we have what every politician needs,
and will listen to:
OUR
VOTE
THEIR
future is in
OUR
hands.
You have nothing to lose, but a great deal to gain - so do it now!
Commit Your Vote and - Together, We Can Do It!
The more votes we have, the greater our strength - the greater our success.
If you have permission to commit the Votes of Family members,
Please complete this form
again for EACH Family member
and enter THEIR Name.
The same email address can be used.
Name:
*
First
Last
Email
*
We will not disclose your name, or share, rent or sell your email address.
SURVEY
This Survey is to help us gain demographic information and is confidential.
Electoral Constituency
*
Are you Male or Female
*
Male
Female
Please choose one of the following
*
Married/co-habiting
Single/not married
Separated/Divorced
Widow
Widower
Which age group are you?
*
18-25
26-35
36-45
46-55
56-65
over 65
How many people in total live in your home
*
1
2
3
4
More than 4
How many people in total have a Vote in your home
*
1
2
3
4
More than 4
How many people in total have a Vote in your home
How many in your household have a Salary/Wage including Part-time work
*
0
1
2
3
4
More than 4
Are you the Person liable to pay the Property Tax - Your vote still counts if you are not liable
*
Yes
No
Are you ....
*
Employed Full time (includes Self-employed)
Employed Part-time (includes Self-employed)
Not Employed
Disabled
Retired
Submit