LITTER LEAGUE APPLICATION

Litter League Application

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

Name of Sponsor/Team
(as will appear on the Leaderboard):
 
Sponsor Address:
 
 
 
Phone Number :
 
Email:
 
Web Site:
 
Authorized Representative (all information will be sent/requested from/mailed to):
Name:
 
Address:
 
   
City, State, Zip:
 
Phone (home):
 
Phone (cell):
 
Fax:
 
Best Time/Place to Call:
 
E-mail:
 
Preferred method of receiving and reporting information:
  E-mail
Mail
Fax
   
Zip Code for litter collection (be as specific about area as possible--ex. Westbrook Rd., from Wellbaum to Crestway in Clay and Randolph Townships):
 
Alternate area choice:
 
Anticipated Number of Participants (16 Max):