Gathering data at subscription time

I recently received a survey from my Congressional Representative. She wanted to know what I wanted her to focus on in the coming year. I decided to go ahead and answer the survey, as I have some rather strong opinions on some of the stuff happening in Congress these days.
The email itself was pretty unremarkable, although quite well done. I was as much interested in answering the survey because it’s one of the few emails I’ve seen with an embedded survey.

I was a little unnerved by the note at the bottom, under the submit button. “By clicking submit you will automatically be opted into receiving regular updates from my e-newsletter.” It’s not necessarily that I mind being opt-ed in, but I get mail from her often enough that I’m pretty sure that I’m already opted in. But, OK, I clicked submit.
I noticed this was being hosted on a website called address-verify.com. OK, so it’s been outsourced to a 3rd party. But what I saw on the website caused me to recoil in horror, both as a email recipient and as an email expert. The “subscription page” doesn’t look like it was intended to be shown to the general public. (Click on the image to see the full form)

My first reaction was “You can not seriously expect me to give you all of that data! And why are you asking for my email address, you have it! You sent me email!” Then I started looking at the form a little harder and it actually looks like an internal form used to track constituent contact and not one that was supposed to be exposed to recipients.
I’m sure this is all valuable information for my rep to have, but I’m not going to spend a lot of time filling out the long form. It’s too much to hand over.
I’m disappointed. I actually wanted to give my Rep. the information she was asking for. And I happily answered the survey in the email. I really appreciated the initial email and the subscription notice on the email. It seemed like a well put together campaign and I am happy to give her my feedback. I’m not sure anyone at the office actually looked at the landing page before the email was deployed.
Unfortunately, this is not as uncommon as it should be. Sometimes senders don’t pay attention to landing pages and actually check mails before deploying them, particularly when they’re sending something new. In this case, they lost the chance to engage more with me. And I lost the chance to engage more with them as I just don’t want to spend 20 minutes filling out pages and pages of a survey.