Community Cans Program Interest Form

Community Cans is a public private partnership program where the City of Philadelphia partners with community organizations and businesses to support community responsibility for clean business districts and commercial areas in Philadelphia neighborhoods. Please use this form to provide information about your organization and your interest in sponsoring Community Cans. After you've submitted your form, a representative from the City of Philadelphia will get in touch with you to discuss participation in the program. Thank you for your interest in participating in the Communty Cans Program, and please reach out to CleanPHL@phila.gov with any questions.

Contact Person Name *

First Name Last Name

Contact Person Phone Number *

Area Code Phone Number

Contact Person Email *

example@example.com

Organization Name *

Organization Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Is your organization incorporated and insured? *

Yes No

Organization Service Area Boundaries *

Proposed Commercial Corridor for Community Cans Program *

Please describe your organization's capacity for procurement, maintenance, and design of the cans. *

Do you foresee any challenges with trash cans placed through the Community Cans Program (like vandalism, dumping of household trash, etc.)? If so, please describe those potential challenges here. *