Be Litter Free Interest Form
Please complete the form below to volunteer for a cleanup or to adopt-a-block to clean.
Full Name
*
First Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
*
Choose all that apply.
*
I would like to join the monthly District 1 cleanups.
I would like to adopt-a-block to keep clean.
I would like more information about other ways I can keep District 1 clean
For adopt-a-block, please list block(s) you would like to adopt. (Ex. 900 block of 123rd Street)
Do you need supplies?
Yes
No
Apply
Should be Empty: