Citywide Clean Up Site Registration Information

Partner Organization Contact Information

Organization or Group Name:

Contact:

Mailing Address

Daytime Phone Number

Email Address:

Site Information (If same as above, indicate "same as above location"

Volunteer Sign-In Location:

Volunteer Coordinator(s)

Coordinator Contact Information:

Name:

Contact Number:
 

              Specific Cleaning Boundary

Street Addresses

If Cleaning Multiple Locations List Boundaries of Cleaning Area

                 Volunteer Information

Total Number of Volunteers for the Event

Total Number of Volunteers Identified

Total Number of Volunteers requested (if any)

Brief Project Description and Current Condition of Target Area

Objectives & Achievements for Days Activities

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