Home » Departments » Solid Waste » Keep Montgomery County Beautiful

GREAT AMERICAN CLEANUP 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 upon appointment, at 2550 Sandridge Dr., Moraine, OH 45439.
How did you hear about the Great American Cleanup?
If other, please describe: