Clean Up Request Survey Fill out this page to inform CRWC of your requested clean up. Question Title * 1. Are you 18 or older? Yes No Question Title * 2. Would you like to join an existing clean up, or create your own?*If requesting to join please skip ahead to contact info, and leave us a note indicating request. Join existing clean up Create my own Question Title * 3. Requested dates of clean up. Please list three options to allow for supply availability 1. 2. 3. Question Title * 4. Time of clean up. (Two hours is a standard time frame) Question Title * 5. Supplies needed Garbage Bags Gloves Grabbers Question Title * 6. Preferred locations, or area for clean up. (Location will be picked depending on condition, and recent clean up status) 1. 2. 3. Question Title * 7. Number of volunteers <10 10-20 20-30 >30 Question Title * 8. Will this clean up be with a group, if so what is the name of the group? Example: Work, scout, school, or church group? Yes No Name of group if applicable Question Title * 9. Would you like your event shared with the public, or kept private to your group only? Yes, please share this event with CRWC's members and social media follwers No thank you, please keep this event private. Question Title * 10. Are you available to pick up and drop off clean up supplies?*Usual time frame for this is M-F 8:30 am to 4:30 pm Yes No Question Title * 11. Have you volunteered with us before? If so, what event did you participate in? Question Title * 12. Coordinator contact information. Name Phone Number Email Question Title * 13. Notes SUBMIT