Group Name Group Contact or Leader`s Name Contact Address

Group Name
Group Contact or Leader’s
Name
Contact Address
Telephone Numbers
Email
Preferred Litter Picking
Date(s)
Preferred Time(s)
Meeting Point Location
How Much Litter Picking
Equipment Do You Require
(adults and children’s litter
picks are available)
Do you have Insurance?
Where will you leave litter
bags for collection?
Signed
Please submit your completed form to [email protected] or via post to Big
Spring Clean, Civic Pride, Durham County Council Service Direct, St. Johns Road,
Meadowfield, Durham, DH7 8XQ.
All Information provided will be treated in the strictest confidence and in accordance with the Data Protection act 1998