Bassetlaw

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	Bassetlaw District Council Queen's Buildings, Potter Street, Worksop, Notts, S80 2AH
	01909 533533
	01909 501758
	Customer Services
	How To Text Us
	01909 534999 (Emergencies)
	Opening Hours 08:40 - 17:00 (Mon - Fri)

Please fill in and submit this application form if you want to rent an allotment plot.



Title
Forename
Surname

Address:

Telephone Number:

Date of Birth:

Do you have a Yellow Leisure Pass?	Yes No

If Yes, please enter your Leisure Pass Number

Email:
Allotment Details
Name of Allotment Site Required

Plot No: 1st choice
Plot No: 2nd choice

Do you already rent an allotment?	Yes No
If YES please complete the following details:
Allotment Site
Plot No:

I hereby make application for one of the allotment gardens provided by the Council on the site mentioned in question 6. In the event of my application being granted I agree, when required by the Council, to sign an agreement for letting in accordance with the Rules.	Agree Disagree

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Last Updated - 23/02/2012

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