London Clean & Green Report Form

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Helping to keep
London Clean & Green

London Clean & Green
Clean Up Report Form

Clean Up Registration Form

Please complete the form below and SUBMIT upon completion of your clean up. Thank you for helping us to keep London Clean & Green!

Clean Up Report Details:

Contact Information

Name:

Email:

Tel:

*
(Area Code, Phone Number and Local)

Number of participants:

*
(enter a numerical value, ie. 15)

Where did you clean up? (Name of park, intersecting streets, school, etc.)

Where did you leave the garbage for collection (e.g. street intersection, school parking lot, boulevard close to roadway)?

Approximately how many bags of garbage did you or your group collect?

*
(enter a numerical value, i.e. 25)

Approximately how many bulky items did you or your group collect, (e.g. old bikes, shopping carts, sofas, etc.)?

*
(enter a numerical value, i.e. 25)

Additional Comments:

* required fields

Thank you for reporting your clean up activities!

If you have any questions, please or call 519 661-4570.

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