PART A - PERSONAL DETAILS 

THIS FORM HAS TWO PARTS:

PART A – PERSONAL DETAILS
PART B – YOUR REPRESENTATION(S). PLEASE FILL IN A SEPARATE SHEET FOR EACH REPRESENTATION AND RETURN ALL TOGETHER WITH PART A

•	A ‘Guidance Note for Submitting Representations’ is available with instructions on how to use this form at http://www.cambridge.gov.uk/issuesandoptions

•	You can also reply via our online response system at: http://cambridge.jdi-consult.net/ldf/.   Separate instructions on how to use the electronic form are provided on the website http://www.cambridge.gov.uk/issuesandoptions 

PLEASE USE BLACK INK

Name of Individual / Organisation:  

Contact Name: 	
(If an organisation)

Address: 	

	

Postcode: 		

Email:	
	 
        Please tick if you prefer to be  
        contacted by email	

Tel: 	   		  Fax:  		  

If you have appointed someone to act as your agent please give their name and address.  All correspondence will be sent to the agent:

Name of Agent: 	

Contact Name: 	
(If an organisation)

Address of Agent: 	

	

Postcode:  				
Email:  	

	Please tick if you prefer to be contacted 
	by email	

Tel: 	     Fax:  	  

Signature:		
Date:		

Data Protection
The information collected will be processed in accordance with the Data Protection Act 1998. Information from the forms will be stored on a computer database used solely in connection with the Local Plan Review.  Representations will be available to view on City Council’s website, although address and contact details will not be included.  However, as copies of representations must be made available for public inspection, they cannot be treated as confidential and will be available for inspection in full.  

PART B – YOUR REPRESENTATION(S).

PLEASE FILL IN A SEPARATE SHEET FOR EACH REPRESENTATION AND RETURN ALL TOGETHER WITH PART A

PARAGRAPH / QUESTION / OPTION NUMBER		
PLEASE CIRCLE	SUPPORT  / OBJECT	

WRITTEN JUSTIFICATION FOR OBJECTION OR SUPPORT:
PLEASE BE AS PRECISE AS POSSIBLE (CONTINUE ON SEPARATE A4 SHEET(S) IF NECESSARY)	

	

SUMMARY OF REPRESENTATION -  PLEASE SUMMARISE THE MAIN ISSUES RAISED IN NO MORE THAN 100 WORDS	

	

PLEASE RETURN YOUR FORM BY 5PM ON 27TH JULY TO:	
EMAIL:	policysurveys@cambridge.gov.uk	
POST:	ISSUES & OPTIONS CONSULTATION, PLANNING POLICY, CAMBRIDGE CITY COUNCIL, PO BOX 700, CAMBRIDGE, CB1 0JH	
BY HAND:	CUSTOMER SERVICE CENTRE AT MANDELA HOUSE, 4 REGENT STREET, CAMBRIDGE CB2 1BY 
Open from 8am-6pm on mon, tues, wed and fri, and 9am–6pm on thursdays.