Form Center

2. Collection Statistics Form
4. Date*
   Enter the day of the project.
6. Which Trailer Did You Use?*
   -- Select One ---Please Select One - Tool Trailer12' Hydraulic Lift Trailer14' Hydraulic Lift TrailerBoth Lift TrailersTool Trailer and 12' Hydraulic Lift TrailerTool Trailer and 14' Hydraulic Lift TrailerAll Three Trailers
8. Organization Name
   List Name of Organization
9. Project Area
   Describe the project location
11. Project Description
    Describe the project in detail. Describe its impact on the community.
13. Number of volunteers participating:
14. Over 18 years of age*
15. Under 18 years of age*
17. Total Pounds Collected
18. Distance Cleaned or Beautified
    List the approximate distance affected by the project.
19. Number of hours spent collecting:*

    1. .5
    2. 1
    3. 1.5
    4. 2
    5. 2.5
    6. 3
    7. 3.5
    8. 4
    9. 4.5
    10. 5
    11. 5.5

    Please round to the nearest half-hour:
21. REMINDER: Don't forget to report broken items. If not under contract, please return all supplies to the Utility Billing Window at City Hall within 3 days of your cleanup. Formal Adopters will need to restock during contract season (October - December).
23. Group Leader / Contact Name*
24. Phone Number*
26. Email Address
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field