Street Surgery Survey

Dear Resident, Thank you for taking the time to complete this short survey. Your views help me better represent you in Parliament and address the issues that matter to you.

Do you have any concerns or issues affecting you or your local community that you would like Euan Stainbank MP to address?(Required)

Your details: (Optional, but necessary if you would like a response. Where applicable, Euan Stainbank MP’s office might need further details in order to process your case. You will be contacted if this is the case.)

First Name Last Name

Address

Street Address City Post Code Country

Phone

Would you like to receive future communications from Euan Stainabnk MP?(Required)

Yes