Great American Cleanup Online Registration

We Want to Make Montgomery County More Beautiful!

Great American Cleanup Registration Form

(Please use this form if you are planning your own cleanup event)

*Contact Name:
Group/Organization Name:
(if applicable)
*Address:
*City, State, Zip:
E-mail (correspondence will be transmitted by e-mail if listed):
*Contact Phone Number:
Fax:
Brief Description of Cleanup Project (include date/time, special activities, beautification, etc.)
Number of Volunteers:

Adults:

Children (14 and under):

Please estimate the quantity of materials you can use. Quantities may be limited.
Glad Trash Bags (30 gallon): Disposable Gloves:
Certificate(s):
   
Once you receive confirmation of your registration, your supplies will be ready for pick-up Monday-Friday, 7:30 a.m. until 4:30 p.m., or upon appointment, at 2550 Sandridge Dr., Moraine, OH 45439.
How did you hear about the Great American Cleanup?
If other, please describe:

Highlights
2014 KMCB Beautification Grant Winners Announced!
Community Cleanup Program

Having a large community cleanup or need help disposing of waste from a large illegal dump site? Eligible groups can apply for free delivery and pickup of a roll off container, which includes disposal costs. For more information and an application click here.

Application (PDF)
Application (Word)

Keep Montgomery County Beautiful