Organize Your Own Cleanup/Beautification Project

We Want to Make Montgomery County More Beautiful!

Tell us about your project and receive cleanup supplies free!

*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):

Number of Supplies Needed:
# of Bags:
# of Gloves:
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 our program?
If other, please describe: