Have your say on the future of local government in Breckland

Request litter picking equipment

Please read the guidance notes before completing this form.
Fields marked with * are required
Equipment details
1. What equipment do you require?*
  
  Bags
  
  Litter pickers (15 per bag)
  
  Both
2. Where would you like to collect your litter picking equipment?
  
  Dereham - Breckland Council Offices
  
  Swaffham - Iceni Partnership
  
  Watton - Wayland Hall
  
  Thetford - Thetford Town Council
  
  Attleborough - Attleborough Bloomers at Connaught Hall
3. How many bags of litter pickers required? (maximum of 2 for Dereham )
4. What date do you wish to collect equipment? (DD/MM/YYYY)
  
  Day
  
  Month
  
  Year
  
  Please provide at least 10 working days notice
Bags Only
1. Please note we will arrange for the equipment to be delivered to your address (address details to be supplied at end of form)
Are collecting this litter as a group or an individual?*
1. Group
2. Individual
Group Details
1. Name of group