Cleanup Reporting Forms

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* 1. Please share your contact information

Name

Company

Email Address

Phone Number

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* 2. Cleanup Site Name or Address

Name of Site

ZIP/Postal Code

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* 3. Type of Environment

Saltwater (Ocean/Bay/Estuary)

Freshwater (Canal/Lake)

Inland (Park/Street)

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* 4. Date of Cleanup

Date / Time

Date

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* 5. Number of Volunteers

Adults

12-18 years old

Under 12 years old

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* 6. Most unusual item collected

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* 7. Cleanup Summary

Number of Trash Bags Filled

Estimated Weight of Trash Collected

Distance Cleaned (miles)

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* 8. Fishing and Boating

Line, nets, traps, rope, etc.

Foam dock pieces.

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* 9. Illegal Dumping

Appliances

Construction materials

Tires

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* 10. Dead/Injured Animals

Type of animal

Dead/Injured

Entangled (yes/no)

Type of entanglement item

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* 11. Please share photos of your volunteers, the site location, and litter collected! Photos may be used on KCB's social media, reports to Collier County, and future marketing materials for KCB Cleanup events.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 12. Please share photos of your volunteers, the site location, and litter collected! Photos may be used on KCB's social media, reports to Collier County, and future marketing materials for KCB Cleanup events.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 13. Please share photos of your volunteers, the site location, and litter collected! Photos may be used on KCB's social media, reports to Collier County, and future marketing materials for KCB Cleanup events.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 14. Please share photos of your volunteers, the site location, and litter collected! Photos may be used on KCB's social media, reports to Collier County, and future marketing materials for KCB Cleanup events.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File