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Litter Pickup Signup
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* Indicates required question
Email
*
Your email
Name (First, Last)
*
Your answer
Do you represent a business or organization?
*
Yes
No
If you answered "Yes," what is it?
Your answer
Do you already have a specific area where you would like to complete the litter pickup? If not, we will help you find one.
*
Yes
No
If you answered "Yes," where would you like to pick up?
Your answer
How many total people will be completing the pickup?
Your answer
Would you like us to provide supplies? We provide trash bags, trash pickers, gloves, and vests.
*
Yes
No
Is there a specific date on which you would like to do your litter pickup?
*
Yes
No
If you answered "Yes," when would you like to complete your pickup? (Please note that we may not be able to accommodate dates occurring within two weeks of form submission).
MM
/
DD
/
YYYY
Any other questions/comments?
Your answer
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