Heritage Asset Listing Submission Form For the General Public to submit items of local interest to appear before the panel for the Heritage List. Name* First Last Phone*Email* Enter Email Confirm Email District Choices*--BacupRawtenstall & BalladenHaslingden & AcreCrawshawbooth, Goodshaw & LovecloughWeir, Broadclough & SharneyfordWhitworth, Shawforth & BritanniaStacksteads, Waterfoot & CowpeHelmshore, Irwell Vale & Bent GateNewchurch & CloughfoldEdenfield, Stubbins, Turn Village, Chatterton & StrongstyPlease choose the district in which your chosen asset resides.Please describe your chosen asset.*e.g. Domestic/Agricultrual/Commercial/Educational/Industrial/Transport/Place of Worship/Street Furniture/Park or GardenAddress of your chosen asset if it is a building Street Address Address Line 2 City County / State / Region ZIP / Postal Code Geo Co-OrdinatesEg: 53.702594 -2.201280Approximate Age of the Asset.Pre 17001700 - 18401840 - 19141914 - 1950Post 1950Please select one of the choicesDo you know who the owner is?YesNoIf yes please provide name and contact details.Does it have notable level of architectural or artistic interest?YesNoIf yes please explainDoes the asset have any historic importance?YesNoIf yes please explainDoes it have any historic association with the community or cultural group in the local area?YesNoIf yes please explainDoes the asset have any evidence of past human activity?YesNoe.g. Historic Quarry Workings/Archeological Remains If yes please explainPlease attach two photographs of your chosen asset Drop files here or Accepted file types: jpg, png, pdf. GDPR* Select All Email Direct Mail Automated Communication Community Assets Standing Tall will use the information you provide on this form to be in touch with you and to provide updates and marketing. Please let us know all the ways you would like to hear from us. You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from us, or by contacting us at [email protected] We will treat your information with respect. For more information about our privacy practices please visit our Privacy Policy. By clicking above, you agree that we may process your information in accordance with these terms. CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
