Great American Cleanup Registration Form

Name of Group:
Contact Person:          Phone: 
Address:
City:      State:      Zip:
Date of Cleanup:
Location of Cleanup:
Number of Volunteers:
Number of Trash Bags:
Do you need the bagged litter collected from your cleanup site?
Will you separate recyclables from the litter?
Have you registered with us before?
How would you like to receive materials?