2018 Winter Wipeout

Help Wipe Out Litter This Winter!

Name *

First Name Last Name

I am signing up for (please check one) *

a group, club, or organization my family myself Adopt-A-Street Partner

Group, Organization or Neighborhood

Estimate # of adult volunteers (18 and older) *

Estimate # of youth volunteers (under 18) *

Do you have a cleanup site? *

Yes No

Please specify the location of your selected cleanup site by listing name of street, intersection, neighborhood, school, stream, etc.

We can help!

Click on the link below to select from the available cleanup sites.

Enter your selection below.

Please list the date between February 8 and February 24 when your cleanup is to take place *

Email *

example@example.com

Event Day Phone *

- Area Code Phone Number

Address