Lewisham Deptford Labour Party


	To enable us to continually improve our services, we aim to get to know you a little better each month.

Who do you support?

Please fill in the form below. Fields marked with an asterisk (*) must be filled in.

Title*
First Name*
Surname*
House No/Street Name*
Town*
Post Code*
Phone Number:
Email address:*

Do you want to pledge your support for the Labour Party?
Which party will you vote for at the May local elections?*	If other please state the name of the party below
Which party did you vote for at the last election?*	If other please state the name of the party below
Would you like to volunteer to help the Labour Party? You don't have to be a member to volunteer.
Would you like to become a member of the Labour Party?
Would you like to receive emails from the Labour Party about our work in Lewisham Deptford?*
Would you like a Labour Post at election time?
We want to know your issues views. By telling us what is important to you we can ensure we work to reflect your views.	Crime & Anti-Social Behaviour Education Environmental Issues Housing Transport Public Services
	Other - Tell us what it is and why it is important to you.