New Year, New Campaigns

1. Please tell us what issues you think we should be campaigning on in the future and why?

2. What motivates you to get involved in a campaign?

3. In what ways are you interested in campaigning with us?

	Just to do an e-action once in a while
	Would be interested in attending a debate in parliament or other campaigns related event
	Would like to help out at a campaigning event
	Would like to get more involved in local campaigning
	Interested in training in developing my campaigning skills

4. How often would you like us to contact you?

	Once a week
	Once every two weeks
	Once a month
	Other (please specify)

5.

Are you signed up to any other campaign networks?
If yes which ones?

6. Any additional comments

7. About you

We would also like to find out more information about you to help us develop our campaigners’ network. Answering these questions will help us to create a better picture of who are active campaigners are, how we can best work together, and also help us identify who we are not yet reaching.

Please could you tell us

Your prefered name

8. Are you male or female?

9. Please tell us how old you are?

10. Do you consider yourself disabled?

	Yes
	No
	Prefer not to answer

11. How would you like to be contacted?

	Email
	Post
	Telephone

12. Your address