District 12 Community Cleanup
Saturday, March 20th
Full Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact No.
-
Area Code
Phone Number
Clean Up Street/Area
Please list neighborhood or streets in which clean-up will occur
Trash Pick-Up Location
Please list address or intersection where collected trash bags will be placed for Solid Waste Management Pick-Up.
Number of Volunteers in Group
This is to make sure we have enough supplies for all volunteers
Submit Form
Should be Empty: