Bookstart - Request for Information Form

Please provide contact details for the Parent /Guardian who wishes to receive the information.

First Name ^*

Surname ^*

Address Line 1 ^*

Address Line 2

Address Line 3

Postcode ^*

Telephone Number

E-mail Address

Age ^*

0 - 14 Months

15 - 35 Months

36 - 48 Months

If you are seeking information for more than one child and they are different ages (under four), please use the 'ADD' button to continue. This will enable us to send you the correct information.

If you have any queries, please contact Sue Wink on 01472 323621, or e-mail sue.wink@nelincs.gov.uk

Please click on the "Submit" button once to send us your form

DATA PROTECTION NOTICE
North East Lincolnshire Council is a Data Controller for the purposes of the Data Protection Act 1998. Any personal information supplied on this form will be processed in accordance with the principles of the Act. If you want to find out more about your rights under the Act, you can contact the Office of the Information Commissioner (tel: 01625 545 700 / http://www.dataprotection.gov.uk) or the Director of Law and Democratic Services on 01472 313131.

Feedback	:	Make a suggestion \| Make a complaint \| Make a compliment \| Report a problem with this page
Created by	:	Archivist
Last Updated	:	06 May 2008



© 2003-2008 North East Lincolnshire Council, Municipal Offices, Town Hall Square, Grimsby, DN31 1HU, Tel No: (01472) 313131	Privacy Policy \| Terms & Conditions Other Languages & Formats