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Rising Prices Survey

Thank you for taking the time to complete this survey.

Full Name (required)

Address (required)

Telephone

Mobile

Your Email (required)

How much has the cost of your weekly shop gone up over the last six months?

 £5 - £10 £10 - £15 £15+

How much has the cost of filling up your car with fuel gone up over the last 3 months?
  £5 - £10 £10 - 15 £15

Which rising costs are you most concerned about?

 Fuel for car Heating VAT Food prices Child benefit changes Child tax credit changes Expansion of higher rate tax bracket Other

How would you rate my work as your MP? (1 being poor 5 being excellent)
 1 2 3 4 5

Can you help deliver parliamentary leaflets for me down your road?
 Yes No Maybe

I think it is important to keep you upto date with what is happening locally and in Parliament. I may contact you using the details you provide. If you do not wish to be contacted, please write to me via the contact Luciana page and let me know.