Application or Enquiry

Making South Derbyshire a healthier, more prosperous and safer place to live...by offering value for money services

Crocus seen by Foremark Reservoir

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Application or Enquiry

Please use the form below to make a request or an enquiry relating to one of our services. Please make sure that we have all of the information necessary; for example if you are requesting an application form, please make sure that you tell us your full address.

page ref: SDDC 8f

Application / Enquiry

Fields marked with '*' are required fields.

Name:	*
Address:
Contact telephone number:	*
Email address:	*
Preferred method of contact
Account ref (if relevant):
Which service does this enquiry / application relate to?	*
Details of your enquiry:

Data Protection: This form is not secure. Please don't include any confidential or sensitive information on it. We will treat any other personal information you provide in confidence and under the Data Protection Act 1998. We will hold it and only use it for a legal reason or for the purpose it is given. We will only share information when we have your consent or we need to ask another department or partner to respond to a specific comment or request you have made.

We will keep a record of the sender's Internet Protocol address (which is unique to the sender's computer), the date we received the form, and the content for back-up and archive purposes. We will also use this record to identify senders of any malicious content under the Protection from Harassment Act 1997. We will keep this record for a maximum of three months.

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