Nassau County Liberal Party Survey

Name:
Address:
City:
State:
Zip:
Phone Number:
E-mail:
Party Affiliation:
What do you think are the 3 most important issues facing the Nation as a whole:
What are the 3 most important issues of a local nature:
If you could speak to the County Executive, what would you ask or tell him:
Have You voted in the last three elections:	Yes: No: