1. Your Name / Address / Phone / Email:
(THIS INFORMATION WILL NOT BE USED FOR PUBLICATION)

Name:

Street address:

Phone:

Email:

2. Did You Vote?
Yes
No

3. Which Party did you vote for?
Liberal Conservative NDP Bloc Quebecois Green Independent Other (please specify)

Other:

4. Age Group
Under 25 25 - 45 46 - 65 Over 65

5. Gender
Male
Female

6. City

7. Province
AB BC MB NB NL NT NS NU ON PE QC SK YT

8. Riding

9. Which items in the following list influenced the way you voted? (select as many as apply):
Candidate's track record
Candidate's views on issues that concern me
Party policies
CIC's national election research reports
Local recommendations
All-candidate meetings
Televised leaders' debates
Other (please specify)
Other:

Submit this form by clicking Submit below