Forms Demo

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Please enter your details below and we will be in touch with you shortly.

Introduction

Navigate through the different form sections using the navigation on the left, or use the next/previous buttons located at the bottom of each step.

Save Your Progress

You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address.

Clicking the next/previous button will automatically save your form.

Note: Incomplete forms are kept for a period of 48 hour(s), after this time the system will automatically delete your response.

Your Details


Survey

Have you visited the Visitor Centre in the last year?
Are you a resident of the Shire of Wongan-Ballidu?
How would you rate our library facilities

Validate and Submit Form

 
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Past Responses

  • First Name Samuel
    Last Name MacLachlan
    Address 7 Chapman
    Phone Number 99208500
    Email samuel@marketcreations.com.au
    Have you visited the Visitor Centre in the last year? No
    Are you a resident of the Shire of Wongan-Ballidu? No|Geraldton
    How would you rate our library facilities 10
    Would you recommend our town to friends? Yes, absolutely!

 

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