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Litter picker loan form

To register your litter pick and request litter pickers, please complete the following form;

Name

First name

Last name
Address

Address Line 1

Address Line 2

City

County

Postcode

Country
Email
Contact number
Date of litter pick
Time of litter pick

Hours

Minutes

Seconds

AM/PM
Location of litter pick
Number of litter pickers required
Number of bags required
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