Neighborhood Winter Cleanup Tool Request Form
Please complete the form below and someone will get back to you to discuss your event and what resources are available to assist you in your cleanup event.
Date of Cleanup
*
-
Month
-
Day
Year
Date
Start Time of Cleanup
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
End Time of Cleanup
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location of Cleanup
*
Location
Cross Streets
City
State / Province
Postal / Zip Code
Name of Organization
*
ABC Neighborhood Association
Number of Participants
*
How many people are participating in the cleanup?
Contact Name
*
First Name
Last Name
Contact Email
*
example@example.com
Contact Phone Number
*
-
Area Code
Phone Number
Best Way to Communicate?
*
EMAIL
PHONE
Other
Organization Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What tools and/or materials are you requesting?
Amount Requested
Salt
Shovels
Ice Pickers
Other
Comments
Upload a file:
Browse Files
File or photo pertaining to your request.
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of
Submit
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