Thank you for participating in our local survey. We only have four questions.

Full Name *

Address *

Street Address *

I explicitly consent to Reform UK (Millbank Tower, 21-24 Millbank, London SW1P 4QP, UK) collecting and processing my personal data (name, address, postal code, phone, email) and special category data (political opinions, voting intentions) for democratic engagement, including surveying, campaigning, and supporting candidates, during and outside election periods. My data may be shared with third-party campaign tools but won’t be sold or used for unrelated purposes. I can withdraw consent at [email protected] and have rights to access, rectify, or erase my data (see reformparty.uk/privacy_policy). I am over 16.

What is the most important Local Issue to you: *

SLASH COUNCIL WASTE

SUPPORTING SMALL BUSINESSES

NO TO 4 DAY WEEKS Public officials should pay their way like we do.

FIX ALL POTHOLES

MORE SOCIAL HOUSING FOR LOCAL PEOPLE

ZERO TOLERANCE ON CRIME AND ANTI-SOCIAL BEHAVIOUR

STOPPING THE 10,000 EXTRA HOMES PLANNED FOR THE GREEN BELT

Finally, can you help Reform UK stand up for our local area by:

If you are able to help locally please provide your contact details below.

Phone (Optional)

Email (Optional)