* Denotes that the field is mandatory.


Note: some fields are mandatory and must be completed before this request can be processed
Where is the litter? *
Details of the park or beach name where the
litter is located (if applicable)
The exact location of the litter *
What sort of litter needs to be cleaned up? *
Did you witness the rubbish being dumped?
Details of the person or car involved in dumping
the litter (if known)
Is there anything in the rubbish which could
identify the person responsible?
Name *
Mobile
Home phone
Email
Postal address *