Workplace 20 Minute Makeover - 2021 Spring Up to Clean Up Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for participating in Spring Up to Clean Up! After completion of your registration the confirmation page will have instructions for your kit pick-up, PLEASE READ! If you have additional questions please contact 624-2140, or melissa@ecosuperior.org. Thank you for helping to keep Thunder Bay Clean, Green & Beautiful!

Email *

CONTACT INFORMATION

Contact Name: *

Phone Number (Optional):

Workplace Name: *

As you would like it to appear on our website and in other forms of participant recognition on social media and in local media outlets.

I consent to the disclosure of the workplace name for recognition purposes. *

Yes

Please indicate if this business has participated in the 20 Minute Makeover before. *

Yes

Unsure

CLEAN UP DETAILS

Expected Date of Clean Up: *

Clean Up Location: *

Please be as specific as possible.

Number of Participants: *

CLEAN UP KIT

Clean-up Kit Size *

Please select the size

Small (5 curbside limit free garbage bags, 2 recycle bags, 2 pairs of gloves, Information package)

Medium (10 curbside limit free garbage bags, 4 recycle bags, 4 pairs of gloves, Information package)

Large (15 curbside limit free garbage bags, 6 recycle bags, 6 pairs of gloves, Information package)

Required

Will you need any of the following additional items?

Landfill Pass (good for 1 trip to the Solid Waste and Recycling Facility to dispose of Spring Up to Clean Up waste only)

Pocket ashtrays (please indicate quantity in comments)

Garbage pickers (MUST BE RETURNED following your clean up, please indicate quantity in comments)

Cigarette butt collection can (MUST BE RETURNED as part of our cigarette recycling program)

Extra gloves (please indicate quantity in comments)

ADDITIONAL INFORMATION

How did you hear about Spring Up to Clean Up? *

Radio

Print Ad

EcoSuperior Website

City of Thunder Bay Website

Social Media (Facebook, Twitter)

I am a past participant

Other:

Questions/Comments?

If you need multiple kits due to work from home restrictions or other reasons, please leave a note here with how many kits and sizes, as well as any other details we should know about (e.g. will there be multiple pick ups from different staff members, etc.)

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms