Please select your area.(required) Tredegar Park Pill Ringland Graig Alltyryn Which of the following issues matters most to you?(required) Health Crime Public Transport Immigration The Environment Pensions Affordable Homes Education Jobs Other If Other - state below Health: Have you had difficulty with any of the following recently?(required) Getting a doctors appointment Registering with a dentist Getting a doctors home visit Other health service issue If other- state below Littering & Dog fouling: How do you rate the cleanliness in your area?(required) Excellent Good Satisfactory Poor Policing: How do you rate the level of policing in your area?(required) Excellent Good Satisfactory Poor Which of the following best describes you? Employed Self-employed Unemployed Retired Voluntary Worker Carer Disabled Student Jobs: How do you rate opportunities in your area?(required) Excellent Good Satisfactory Poor Age: which age bracket do you fall into?(required) less than 16 16-18 18-25 25-35 35-45 45-55 55-65 65+ Name(required) Telephone Address Post Code: Email Up your street… Are there any specific issues in your local area you would like to raise - for example pavements or road conditions, bus service etc? I'd like to speak to a local Plaid Cymru representative about a local issue. I’d like more information about Plaid Cymru I’d like to be kept updated about elected members work Thank you for your time. We will not share your details with any third party.