PA CLEANWAYS LITTER HAWK PROGRAM
Booklet Order Form

Instructions: print this page, fill out the form below (please
print neatly!), and mail it to:

PA CleanWays, Inc.
105 West Fourth Street
Greensburg, PA 15601
Attention: Barb


Name ______________________________________________

Mailing Address (No P.O. Boxes) ________________________

___________________________________________________

City, State, Zip ______________________________________

Telephone __________________________________________

E-mail Address ______________________________________