Feedback Form

We would like to get your views on what you expect Basildon Council to do for you.
Please fill in this form as completely as you can.

There are only two mandatory fields.
1. The drop down list for you to select policy areas which concern you.
We request that you enter only 3 items on the list of policy areas. If you fill in more that 3 fields we will use only the first three checked.

2. The first line of your address and postcode
We require your house details to help us verify that you are a Basildon Borough resident.

All other fields are optional.

GDPR information. We are collecting personal information to ensure that we only consider survey data from residents of Basildon Borough. We will not pass this information on to any other person or body. By completing the information you are agreeing to us contacting you by email or phone using the data supplied to us. This will enable us to verify your responses if needed. We will not use the information supplied to us for any other campaigning activity without prior agreement with yourself. By clicking on the ‘Send Feedback’ button you are agreeing us using the information you supply in the way we have indicated in this notice.