First name
Last name
Email
Mobile
1.
What suburb do you live in?
Please select
Churchlands
City Beach
Doubleview
Floreat
Glendalough
Scarborough
Wembley
Wembley Downs
West Leederville
Woodlands
Other - not in Churchlands
Innaloo
2.
What is the MOST important issue facing our community?
Please select
Affordable housing
Cost-of-living pressures
Climate change action
Environmental protection
Sustainable development and urban planning
Education and schools
Healthcare and local services
Traffic, parking, and public transport
Support for business and jobs
Integrity in Politics
Other
3.
What is the SECOND MOST important issue facing our community?
Please select
Affordable housing
Cost-of-living pressures
Climate change action
Environmental protection
Sustainable development and urban planning
Education and schools
Healthcare and local services
Traffic, parking, and public transport
Integrity in politics
Support for business and jobs
Other
4.
What solutions do you think would help ease the cost of living pressures in Churchlands and across WA?
5.
What do you like most about our community?
6.
If you could change one thing in our community, what would it be?
7.
Do you welcome the opportunity to vote for a community-first independent candidate in Churchlands?
Please select
Yes
No