2012 Good Neighbor Community Days Re-Scheduled

Post Project Results Form

For Great American Cleanup

Contact Information

Project Leader Name(Required)

First Last

Organization/ Group Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email(Required)

Results

Describe the impact of your project below, or attach additional files if needed.

Project Category (pick one)(Required)

Project Date

Project Location

Project Description(Required)

Describe the work that was completed and the feedback you received from your volunteers and the members of the community.

# of Volunteers(Required)

This includes anyone donating their time to work on this project.

# of Volunteer Hours(Required)

This includes the total number of hours volunteered per person (example: 5 volunteers work for 2 hours = 10 Volunteer Hours)

# of Bags of Litter Collected

# of Miles of Road/Stream Cleaned

# of Trees/ Flowers Planted

# of Bags of Yard Debris Cleaned

Upload Photos

Show us your impactful work! Please upload 1-3 "after photos."

File(Required)

Max. file size: 50 MB.

File

Max. file size: 50 MB.

File

Max. file size: 50 MB.

Dial-a-Dumpster

Name(Required)

First Last

Group/Organization Name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Please give a potential date for when you'd like to complete your event(Required)

Date should be at least 10 business days from today's date.

What type of location do you wish to cleanup with Dial-a-dumpster?(Required)

Business area

Neighborhood communal area

Park area

Other

If other, please describe.

Please describe where in your community you wish to cleanup, what types of items or materials need to be removed, and how this will benefit your neighborhood or business.(Required)

File

Max. file size: 50 MB.

Give an estimate of how many people will be participating.(Required)

Groom and Bloom

Name(Required)

First Last

Group/Organization Name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Please give a potential date for when you'd like to complete your event(Required)

Date should be at least 10 business days from today's date.

What type of location do you wish to beautify?(Required)

Business entrance

Neighborhood entrance

School

Other

If other, please describe.

Please describe why you wish to pretty-up this place, what types of plants are being requested, and where they will go.(Required)

What gardening tools are needed to complete the project that you and your team do not already have?

Give an estimate of how many people will be participating.(Required)

Litter League

Name(Required)

First Last

Group/Organization Name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Please give a potential date for when you'd like to complete your cleanup

Date should be at least 10 business days from today's date.

Please choose what type of cleanup you are most interested in doing

Road Cleanup

Stream/ Waterway Cleanup

Both

Do you have a location in mind for your cleanup?(Required)

Yes

No, I need help selecting one.

If yes, please provide an address or the nearest intersection to the location.

Give an estimate of how many people will be participating.(Required)

Do you have a certain number of hours you are wanting to work?