Environment

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Supporters of Sustainability Challenge Pledge

I/we will make a conscious choice to reduce my/our impact on the environment. I/we understand that making a difference can be as easy as a few changes in my/our daily routine. I/we want to join Blacktown City Council in caring and protecting for our city, our country and our world and work towards a better future.

I/we pledge to join the challenge and

Join up by 30 June 2007 to be in the running for some great prizes!

My/our details are:

Family Name		Initial/s
Address
Suburb		Post Code
Email Address

I/we understand my/our name will be published on Blacktown City Council's website.

- Tick here if you do not want your name or suburb published

I/we would like to be kept informed and receive more information about Blacktown City Council environmental programs.

- Tick here if you do not want to receive further information

My/Our preferred method of contact is Email / Post

The personal information provided in this form will be stored and used for the purposes of Blacktown City Council programs and will be accessed by relevant Council staff only.