Feedback Form

You could WIN a prize by sending in your feedback!

You'll get the chance to see and experience a different side of your district through your prize package, designed especially for you by Tourism Coromandel in partnership with local tour operators. The first 30 feedback forms we receive back will also get a special reward - a native plant voucher - for you to use to contribute to the future of our district.

 

Your Details
First Name: Surname:     Postal Address: Suburb: Town: Usual Resident Non Resident   If non-resident ratepayer, property(ies) is located in:     Email: Phone: Mobile:     Send me email newsletters about the Blueprint’s progress: Yes No Feedback Closes: 4pm, Friday May 30, 2008
Please indicate which Preferred Future you believe best addresses each key issue, and their importance to the district:
Future 1 Business as usual Info Future 2 Two major centres Info Future 3 Four major centres Info Future 4 Dispersed villages Info
Landscape, Open Space and Biodiversity	Select One Future 1 Future 2 Future 3 Future 4	Select One High Importance Medium Importance Low Importance
Character of Our District	Select One Future 1 Future 2 Future 3 Future 4	Select One High Importance Medium Importance Low Importance
Natural Hazards	Select One Future 1 Future 2 Future 3 Future 4	Select One High Importance Medium Importance Low Importance
Economy and Infrastructure	Select One Future 1 Future 2 Future 3 Future 4	Select One High Importance Medium Importance Low Importance
Which do you think is the best ‘Future’ overall?
One Two Three Four None
If you ticked ‘None’ please tell us why, and what your ‘Preferred Future’ would be:
Other Comments
To help us analyse the feedback, please select your age and your gender:
Under 20 20 - 30 30 - 40 40 - 50 50 - 60 60+ Select Gender Male Female