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December 2013 Constituent Survey
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Do you believe Hydraulic Fracturing in Ohio should be stopped?
Choose
Yes
No
Undecided
Would more people adopt children from Ohio if the process ran smoother and cost less?
Choose
Yes
No
Undecided
Have you noticed the growing drug problem in our community?
Choose
Yes
No
Undecided
Compared to last year are you spending more this Christmas or cutting back?
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Spending More
Cutting Back
Staying the Same
Please share any other thoughts you may have regarding issues in the news this month. Any feedback you can provide would be helpful.
Your answer
First Name
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Your answer
Middle Name/Initial
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Last Name
*
Your answer
Suffix
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Mailing Address
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Your answer
City
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Your answer
State
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Choose
Ohio
Other
Zip
*
Your answer
County
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Choose
Mercer
Auglaize
Shelby
Darke
Other
Email Address
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Phone Number
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