Pure Mile Application Form

Total Number of Miles (required)

Please give details of 2 people who we can contact in relation to the competition

Person One:

Your Name (required)

Address (required)

Tel (required)

Mobile (required)

Your Email (required)

Person Two:

Your Name (required)

Address (required)

Tel (required)

Mobile (required)

Your Email (required)

What aspects of The Pure Mile would you like to focus on:

LitterAnti-Dumping InitiativeClean Up The UplandsCommunityEducationNatural HeritageBuilt/Social Heritage

Download Pure Mile Health and Safety Guidelines

Please note that all litter picks and clean-ups are undertaken by volunteers at their own risk.

Additional Information:

I agree to the Pure Project Privacy Policy

I have read the Pure Mile Information Booklet

I have read the Pure Mile Health and Safety Guidelines

Please leave this field empty.