ASSISTED GARDEN MAINTENANCE APPLICATION FORM

Name:  ........................................................................................................................................

Address: ......................................................................................................................................

Tel No: .........................................................................................................................................

Email Address: ...........................................................................................................................

DOB........................................................    Age:  	......................................

Details of disability: ....................................................................................................................

.......................................................................................................................................................

Work required:
						Front     Back
	Grass Cutting				    
	Hedge Trimming			    

You live alone & are physically unable to maintain your garden & have no-one in the district or locality who is able to maintain your garden for you, Or;	YES/NO	
You are in receipt of PIP or Attendance Allowance & are physically unable to maintain your own garden. 
(if yes, please provide proof of your benefits)	YES/NO	

I agree to pay the weekly service charge for a full twelve months as the cost is spread throughout the year. This sum may change annually subject to contract costs.

I understand that if there are arrears on my account the service will be withdrawn. The arrears will then need to be cleared before the service can be reinstated.

Signed	Tenant 1  ...........................................................   Date  .................................

		Tenant 2  ...........................................................   Date  ..................................

													PTO

Equal Opportunities

We want to make sure our services are available to the people that need them, whatever their race, colour or national origin.  The information you give here will help us do this.  What you tell us will not affect your application and you do not have to give us this information.

	Application	Joint Application	
A	White			
	British			
	Irish			
	Any other White background			
				
B	Mixed			
	White & Black Caribbean			
	White and Black African			
	White and Asian			
	Any other Mixed background			
				
C	Asian or Asian British			
	Indian			
	Pakistani			
	Bangladeshi			
	Any other Asian background			
				
D	Black or Black British			
	Caribbean			
	African			
	Any other Black background			
				
E	Gypsy/Romany/Irish Traveller			
				
F	Chinese or other ethnic group			
	Chinese			
	Any other			
				
G	Sexual Orientation			
	Bisexual			
	Heterosexual			
	Homosexual			
	Do not wish to answer			
				
H	Religion			
	Baha'i			
	Buddhist			
	Christian			
	Hindu			
	Jain			
	Jewish			
	Muslim			
	Sikh			
	Zoroastrian			
	Other			
	None			
	Do not wish to answer			

Privacy Notice

The privacy notice explains how St Albans City & District Council (the Data Controller) will use any personal information we collect about you when you use our services.

We will use your information for the purposes we have set out; keep it securely; destroy it when we no longer need it; tell you the rights applicable to this personal information and how to exercise them; tell you who to complain to.

All this information is set out in full on the privacy notice with this form.  

Please read the privacy notice for more details.
Privacy Notice 
This privacy notice explains how St Albans City & District Council (the Data Controller) will use any personal information we collect about you when you use our services.
What information do we collect about you?
The information that the Council will collect varies depending on how you use the Council’s Services. We are using the information provided in this case for a public task (Art. 6(1)(e).  This means we collect your personal information from you so that we can carry out our statutory functions.  In this case we are collecting personal information so that we can assess your needs for the purposes of your assisted garden maintenance scheme application.                                        
If you’re providing us with special category personal information (such as details about your health) we will be processing this under Art. 9(2).  
How will we use the information about you?
We use the information to process your application for the Council’s garden maintenance scheme.                                                ].  We may share the information with other departments at the Council to enable us to deal with your application.  We will only share the information to enable us to deal with this matter.
We will not share the personal information we hold with any external organisations except for partner organisations.  By partner organisations we mean our Garden Maintenance contractors  where sharing your data is necessary to deal with your matter.  We may be required to share your personal information with the Police, Internal Audit or similar agency, or another Council for the purposes of preventing and detecting fraud.
We will ensure that all personal information is kept securely.
How long will we keep this information?
We will destroy this personal information in accordance with our Disposal Schedules.  We consider what the legislation states and what is good practice to determine how long we need to keep your information. This means we will securely destroy the information once we no longer need it.  If you would like to know the specific period of time that relates to your personal information please contact GDPR@stalbans.gov.uk 
Individuals’ Rights
You have a right to request a copy of the personal information that we hold about you.  If you would like a copy of some or all of your information, please contact foi@stalbans.gov.uk and ask for a subject access request. 
If you consider we hold inaccurate personal information about you, you can contact us to ask for this information to be corrected.  If you consider we are using your personal information incorrectly, you can object.  We will consider your request and respond within one month.  Please contact GDPR@stalbans.gov.uk.
You can find out more about your rights on our website:   http://www.stalbans.gov.uk/council-and-democracy/departmentsPoliciesPlans/data-protection/
Cookies
Cookies are text files placed on your computer to collect standard internet log information and visitor behaviour information.  This information is used to make your use of the internet better.  For further information on how we use these and how you can control it, please visit http://www.stalbans.gov.uk/about-this-site/legal-notices/cookies.aspx
Changes to our Data Protection Policy
We have a Data Protection Policy in place and this can be found here: http://www.stalbans.gov.uk/Images/SADC%20Data%20Protection%20Policy%20March%202017_tcm15-57902.pdf
We review this policy annually.  An updated General Data Protection Regulation version will appear here before 25th May 2018.
Data Protection Officer
Our Data Protection Officer for the purposes of Articles 37 to 39 of the General Data Protection Regulation is Charles Turner, Solicitor to the Council.  He can be contacted by emailing GDPR@stalbans.gov.uk or calling 01727 819209 for our Complaints Team.
How to contact us
Please contact us if you have any questions about our Data Protection Policy, or concerns about how we handle your information: by emailing foi@stalbans.gov.uk or write to us at: FOI Team, St Albans City & District Council, St Peter’s Street, St Albans, AL1 3JE.  
Complaints 
You have a right to complain to the Information Commissioner if you are unhappy with how we process your personal information.  You can do so through their website:  https://ico.org.uk/concerns/ or by emailing: casework@ico.org.uk or calling their helpline on 0303 123 1113.