Project Treasure Application Form
This form is to apply for a ‘Project Treasure’ seatbelt cover. If your application is successful, you will receive a confirmation email and your seatbelt cover will be posted to you. Please note, any personal information provided will not be shared.
Full name (of the person that is receiving the seatbelt cover)
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Age group
*
Please Select
0-12
13-18
19-25
26-40
41-65
Over 65
Address
*
Street Address
Street Address Line 2
City
County
Post code
District
Please Select
Wychavon
Malvern Hills
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Please provide information regarding the speech, language, medical and communication needs of the individual you are applying for so that we may assess suitability for a seatbelt cover
*
Data Protection Consent
To allow us to deal with your request, Wychavon District Council will hold and process your information in accordance with Data Protection Law. We may need to share your information with other parts of the council to allow us to do this. We will not use your data for any other purpose other than for responding and dealing with your application. For more information please see our privacy notices on our website.
*
I confirm Wychavon District Council can hold and process my information, as outlined above, to allow my report to be dealt with.
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