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Litter League Application

  1. Additional information will be sent to Authorized Representative, including Waiver/Agreement document.

  2. Authorized Representative (all information will be sent/requested from/mailed to)
  3. Preferred method of receiving and reporting
  4. Please note: Be as specific about the area as possible - for example: Westbrook Road, from Wellbaum to Crestway in Clay and Randolph Townships.

  5. Leave This Blank:

  6. This field is not part of the form submission.