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Isle of Wight Council
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Application for an Assisted Waste & Recycling Collection |
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If not submitting online -
Please complete all sections and sign the declaration. Once completed please
return to:-
Waste Management
Contracts & Procurement
County Hall
Newport
Isle of Wight
PO30 1UD
If this form is completed electronically you may be required to sign a copy at a
later date.
All data will be used in line with the principles of the Data Protection Act
1998 for Council business only.
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Title |
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Forename |
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Middle name/Initials |
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Surname |
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Building/house name/number |
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Street address |
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Town name |
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County |
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Postcode |
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Telephone number
(include area code) |
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Email address |
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Are you registered disabled? |
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Please give an indication of why you require an assisted collection
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If submitting online, please email copies of documentation to support your
application to [email protected] or send to:
Waste Management
Contracts & Procurement
County Hall
Newport
Isle of Wight
PO30 1UD
Please quote the reference number you will be provided with upon submission of
the form with any correspondence.
Suitable documents are as follows: attendance, disability or mobility allowance,
sickness benefits etc. or medical certificate issued by a doctor.
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I need an Assisted Collection
for my: |
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Please tick as appropriate: |
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How many other persons over 18 years old live in your household?(If none please
go to question 3) |
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Please state why they are unable to use the kerbside system: |
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As an alternative to an assisted collection service you may prefer to seek
assistance from neighbours, or request a special trolley for your recycling
box(free of charge) from the Council. |
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Will an assisted collection be required on a permanent basis? |
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*If no please specify date required until |
dd/mm/yyyy |
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I confirm that there is nobody else in the household capable of moving my waste
for collection. I understand that random checks are carried out by Council
Officers to check the validity of applications and to make sure this service is
still required.
I will inform the Council should I no longer require this service. All the
information supplied is correct. |
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Signed:...................................................
PRINT NAME.............................................
Date:......................................................
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Data Protection Act 1998 |
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This application may be monitored by the Isle of Wight Council for regulatory,
quality control or crime detection purposes. Information from this application
will be processed in accordance with the Data Protection Act 1998 for the
purpose of processing your particular enquiry/request. The Isle of Wight Council
("the Council") is the data controller. By completing this form you consent to
the Council contacting you by email or nominated contact method in relation to
your enquiry/request.
The information contained in this application may, in exceptional circumstances,
be subject to disclosure to third parties under either the Data Protection Act
1998 or the Freedom of Information Act 2000 to the extent the law allows and in
accordance with the Isle of Wight Council's Access to Information Policy.
Disclosure will only be made where in all the circumstances it would be fair to
do so and in the public interest.
Please note that the Council may process your information in the absence of
consent for the purpose of crime prevention or detection so far as is in
accordance with the law.
Sometimes we may use your information to keep you informed about services, goods
or relevant issues that we believe may be of interest to you. If you wish to
receive this information for these purposes please tick this box
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To improve the quality of other services that we provide to you the Council
wishes to hold your non-sensitive personal information on a secure central
database. This will enable all Council services to use this information when
they are providing a service to/for you. If you wish your non-sensitive personal
information to be held by the Council please tick this box
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