First name
Last name
Email
Mobile
Gender
Please select
M
F
O
1.
What suburb do you live in?
2.
What is your age range?
Please select
18-24
25-34
35-44
45-54
55-64
65-74
75+
3.
How long have you lived on the Gold Coast?
Please select
Less than 3 years
3-5 years
5-10 years
More than 10 years
4.
What do you value most about living in Moncrieff?
5.
What are your main issues and concerns at the federal level?
6.
What top three qualities would you like to see in your federal representative?
7.
Do you feel you have a say in the way you are represented?
Please select
Yes
Somewhat
Don't know
Not Really
No
8.
Explain why you do - or why you don't feel you have a say in the way you are represented.