Higgins Survey

Please number (from 1 to 4) the four issues that concern you most:

Reducing Australia's debt:

Government waste and mismanagement:

Tackling local crime in our community:

Securing Australia’s borders:

Creating local jobs:

Stopping the carbon tax:

Improving local roads and infrastructure:

Backing small business:

Reducing cost of living pressures:

Securing our water supplies:

Direct action on climate change:

Choice in education:

Investing in mental health care:

Same-sex marriage:

Affordability of childcare:

Other :

If other, (please specify):

If you could fix one issue in your area what would it be?:

First Name (required):

Last Name (required):

Street Address (required):

Suburb (required):

State:

Postcode:

Phone:

Fax:

Email(required):

I USUALLY support the following party:

I ALWAYS support the following party:

Contact Kelly

Suite 1, 1343 Malvern Road,
Malvern VIC 3144

(03) 9822 4422

(03) 9822 0319

Email:

Name:

Postcode: