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Clean and Green

School Visit Request Form

All personal information provided to Derbyshire Dales District Council will be held and treated in confidence in accordance with the Data Protection Act 1998. It will only be used for the purpose it was given and never sold to a third party.
Please enter the name of your school

Primary contact

Please enter the first name of the primary contact
Please enter the last name of the primary contact
Please enter a valid email address
Please enter a phone number of the primary contact

Event details

Please choose a date
Please state time you would like us to visit
Invalid Input