Coastal Cleanup Day 2018: Site-Coordinator Registration Form

Dear Potential Site-Coordinator,

If your neighborhood has a creek, river, or lake that is plagued by litter, we encourage you to register as a Site-Coordinator for that location at our next cleanup event: Coastal Cleanup Day on Saturday, September 15, 2018 from 9 am to noon.

The Creek Connections Action Group (CCAG) is a partnership of the City of Palo Alto, City of San José Departments of Environmental Services and Parks, Recreation and Neighborhood Services, City of Milpitas, City of Cupertino, City of Santa Clara, City of Sunnyvale, Santa Clara County Parks and Recreation, Santa Clara Valley Water District, and various other stakeholder groups. We have sponsored and organized over 40 creek cleanup events including the annual National River Cleanup and California Coastal Cleanup Days since our inception in 1996. To date, we have worked with over 28,000 volunteers who have removed close to a million pounds of trash around Santa Clara County.

As a site-coordinator you will be responsible for volunteer recruitment, volunteer sign-in, review of safety tips, set-up and data reporting at your site on the cleanup day. The CCAG will assist you and train you as well as provide you with cleanup supplies (i.e. gloves, bags, etc.) for all your participating volunteers. We will also provide a web site to register volunteers (www.cleanacreek.org) and we will generate publicity materials to assist in providing information, recruitment and registration of volunteers for your cleanup site. 

Here is how you can get started:

Step 1:
Choose an accessible creek/river or lake site that is in need of a cleanup within Santa Clara County. Many coordinators choose parks or trails that have good creek access, public visibility and minimal vegetation. Please avoid areas with difficult terrain, homeless encampments or with dangerous litter. Make sure to check your site’s condition before registering. If you're not sure where to go, email volunteer@valleywater.org and we will help you locate a site.
 
Step 2:
Arrange for one or two people to serve as Site-Coordinators for the day of the event. The site coordinator(s) must participate in our training meeting/supply pick-up session on Thursday, September 6, 2018, from noon to 1:30 p.m.  Food will be provided!
 
Complete this registration form by Friday, July 13, 2018.

Participation in this event is a great way to work with residents to protect and care for our local waterways and environment.

If you have any questions or need site suggestions, please send an e-mail to volunteer@valleywater.org.

We look forward to working with you!

- Ricardo Barajas
  Creek Connections Action Group, Chair
  volunteer@valleywater.org
SITE-COORDINATOR CONTACT INFORMATION
First name:

Question Title

* 1. First name:

Last name:

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* 2. Last name:

If you are representing an agency, what agency (i.e. City of San José, Santa Clara County Parks, etc.)?

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* 3. If you are representing an agency, what agency (i.e. City of San José, Santa Clara County Parks, etc.)?

Address:

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* 4. Address:

City:

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* 5. City:

Zip Code:

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* 6. Zip Code:

Phone Number:

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* 7. Phone Number:

Cell Phone:

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* 8. Cell Phone:

Email:

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* 9. Email:

Website (if applicable):

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* 10. Website (if applicable):

CLEANUP SITE INFORMATION
Name of creek, river, or lake:

Question Title

* 11. Name of creek, river, or lake:

Closest street address to cleanup site (i.e. 2456 Creekside Rd. Palo Alto, CA ):

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* 12. Closest street address to cleanup site (i.e. 2456 Creekside Rd. Palo Alto, CA ):

What city/town is the cleanup site in? (i.e. San Jose, Cupertino, Santa Clara, Palo Alto, etc.):

Question Title

* 13. What city/town is the cleanup site in? (i.e. San Jose, Cupertino, Santa Clara, Palo Alto, etc.):

Starting and end points of cleanup (i.e. list cross street; Mckee Road and King Road):

Question Title

* 14. Starting and end points of cleanup (i.e. list cross street; Mckee Road and King Road):

Select "Yes" if you currently have an active permit to cleanup the creek location above (i.e. current Adopt-A-Creek Program partner, etc.).

Select "No" if this is your first time participating and you do not have a permit.

Select "I don't know" if you are not sure.

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* 15. Select "Yes" if you currently have an active permit to cleanup the creek location above (i.e. current Adopt-A-Creek Program partner, etc.).

Select "No" if this is your first time participating and you do not have a permit.

Select "I don't know" if you are not sure.

Is this creek cleanup site, the same one you coordinated for National River Cleanup Day in May 2018?

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* 16. Is this creek cleanup site, the same one you coordinated for National River Cleanup Day in May 2018?

Where will volunteers meet before the cleanup (i.e. Meet at bridge; Meet at south entrance, etc.)?

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* 17. Where will volunteers meet before the cleanup (i.e. Meet at bridge; Meet at south entrance, etc.)?

Number of volunteers needed (please estimate if not sure):

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* 18. Number of volunteers needed (please estimate if not sure):

Other information about this site (including level of litter, safety concerns, etc.):

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* 22. Other information about this site (including level of litter, safety concerns, etc.):

If you answered "Yes" on Question 22, where will the collected trash be left at (i.e. On the corner of X and Y; By the bridge, etc.)? Please give a cross street for more accuracy or trash will not be picked up.

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* 24. If you answered "Yes" on Question 22, where will the collected trash be left at (i.e. On the corner of X and Y; By the bridge, etc.)? Please give a cross street for more accuracy or trash will not be picked up.

What personal contact information would you like to list on the website (www.cleanacreek.org) to connect with potential volunteers if they have questions:

Question Title

* 27. What personal contact information would you like to list on the website (www.cleanacreek.org) to connect with potential volunteers if they have questions:

Do you have any other comments, questions, or concerns?

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* 28. Do you have any other comments, questions, or concerns?

Thank you for taking the time to fill out this online site-coordinator form for Coastal Cleanup Day on Saturday, September 15, 2018. You will receive a confirmation email once your site has been verified and approved.

Please note that if the property you intend to cleanup is private property, you will need to obtain permission from the property owners. We cannot grant permission, nor should this form imply, that we grant permission to access private property.

If you have any questions, feel free to email volunteer@valleywater.org. Thanks again for your participation and help in keeping our waterways litter-free.

T