About You

First Name
Last Name
Email
House Number
Postcode
Telephone

Crime & anti-social behaviour

Are any of the following issues a problem in your area? (please tick all that apply)





Up your street

Are any of the following issues a problem in your area? (please tick all that apply)





Your local public services

Please rate the following local public services. (1= Excellent, 5= Very poor)

Health Services
Dental services
Schools & Colleges
Neighbourhood police
West Lancs Borough Council
Lancs County Council
Bus services
Rail services
Waste & recycling

Let MP Rosie know what’s happening with you, your family and your street

What are your top three priorities for your street and local community?
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