Keep It Clean! 2009 Wrap-Up Report

Information:
~Please fill out this form AFTER you have completed your cleanup and/or beautification event(s).
~Tools (rakes and shovels) if borrowed must be returned to our offices at KGMB (1313 W. Mount Vernon Ave.) on Monday between 9am and 3pm.

Facilitated by Keep Greater Milwaukee Beautiful, Inc.

First Name

Last Name

Organization Name

Address

City

State

Zip Code

Day Phone Number

Alternate Phone Number

E-mail

Check your preference for being contacted

E-mail

Phone

Postal Mail

Cleanup Location

Date of Cleanup (mmddyy). If you hosted several cleanups, please list start date.

Start Time of Cleanup

End Time of Cleanup

Number of Volunteers who Participated in Your Event. Volunteers who participated on more than one day should be counted separately for each time they volunteered.

Number of Bags of Litter Collected at Cleanup Event. If you are unsure, please consider the amount of bags you stared with and the number of bags left over.

How did you hear about Keep Greater Milwaukee Beautiful?

Comments/Questions

Don't forget to send us flyers or pictures from your cleanup! (Please send by e-mail.) Thank You!

Initials

Date (mmddyy)

Indicates Response Required