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Litter Free School Zone Program
Thank you for participating in the Litter Free School Zone Program!

To report information about a completed Litter Free School Zone Cleanup, please fill out the following form at the end of your Fall (December 15th) and Spring (June 15th or end of the school year) semesters.

Litter Free School Zone Reporting Form

Name of Person Submitting This Form: (required)
E-mail of Person Submitting This Form: (required)

Check here if your contact information has changed:

Primary Contact Name:
School Address:
Daytime Phone:
E-mail:
School Name:
County:
School Year:

Check one:	December 15th	OR	June 15th
			(or end of school year)

Cleanup Statistics
Total Number of Cleanups:
Total Number of Volunteers Participating:
Total Number of Hours Volunteers Worked: (Number of volunteers multiplied by the number of hours worked)
Total Number of Trash Bags Collected:
Total Number of Bags of Recyclables Collected:
Total Number of Tires Collected:
Total Number of Appliances & Other Large Bulky Items Collected:

Please let us know of any problems or concerns relating to your cleanups:

Please feel free to share interesting stories, unusual items found, quotes, or other feedback about your cleanups:

When you are finished reporting your Litter Free School Zone Cleanup Event information, press the "Submit Form" button below to send:

Please only click the submit button one time. It may take a minute or two.