Community Cleanup – Report

Full Name of Contact Person*
Email of Contact Person*
Phone Number*
Location of clean-up*
Your street address, city, state*
Zip Code*
Name of Organizing Group
Tell us about your clean-up
How did you hear about the Work For Water program and Community Clean-Ups for Water Quality? **
Date of clean-up*
MM slash DD slash YYYY
Location of clean-up*
Number of Bags Collected*
Number of storm drains cleared*
Number of volunteers participating*
Future Activities
Our group would like do a community clean up next year*
- Yes
- No
I would like more ideas and resources for taking action in my community*
- Yes
- No
Phone
This field is for validation purposes and should be left unchanged.

Tell us about your clean-up