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* 1. Your Name: (Optional)

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* 2. When did your activity take place?

Date

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* 3. If your activity is linked to a Cleanup hub, what is the name of the Cleanup Hub linked to this activity?

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* 4. What is the name of your local council / local authority area?

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* 5. Please select your role in today's activity:

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* 6. Which activity did you participate in? Select all that apply.

T