Cleanup Wrap-Up Report

Community Clean Up Program - Keep Horry County Beautiful

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1. Community Cleanup Organization Name: (Required.)

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2. Name of Group Leader: (Required.)

First Name

Last Name

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3. Contact Information:

Email Address

Phone Number

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4. Event Date and Start Time (Required.)

Date / Time

Date

Time

AM/PM

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5. Where did your cleanup take place?

Location 1

Location 2

Location 3

Location 4

Location 5

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6. How many hours did your group spend cleaning? (Required.)

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7. How many volunteers were in your group? (Required.)

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8. How many bags of trash did your group pick up? (Required.)

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9. How many bags of recyclables did your group pick up?

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10. How many miles of roadway did your group pick up?

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11. How many acres of park land did your group pick up?

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12. How many miles of rivers, waterways, and/or beaches did your group pick up?

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13. How many miles of trails (hike and/or bike) did your group clean?

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14. Did your group find any illegal dump sites? If so, where?

Location 1

Location 2

Location 3

Location 4

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15. I hereby confirm that upon submitting of this form all the information above has been provided with the best of my knowledge on the following date: (Required.)

Certification of Wrap Up Report Submission

Date

Time

AM/PM

Cleanup Wrap-Up Report

Community Clean Up Program - Keep Horry County Beautiful

Question Title

* 1. Community Cleanup Organization Name: (Required.)

Question Title

* 2. Name of Group Leader: (Required.)

Question Title

* 3. Contact Information:

Question Title

* 4. Event Date and Start Time (Required.)

Question Title

* 5. Where did your cleanup take place?

Question Title

* 6. How many hours did your group spend cleaning? (Required.)

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* 7. How many volunteers were in your group? (Required.)

Question Title

* 8. How many bags of trash did your group pick up? (Required.)

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* 9. How many bags of recyclables did your group pick up?

Question Title

* 10. How many miles of roadway did your group pick up?

Question Title

* 11. How many acres of park land did your group pick up?

Question Title

* 12. How many miles of rivers, waterways, and/or beaches did your group pick up?

Question Title

* 13. How many miles of trails (hike and/or bike) did your group clean?

Question Title

* 14. Did your group find any illegal dump sites? If so, where?

Question Title

* 15. I hereby confirm that upon submitting of this form all the information above has been provided with the best of my knowledge on the following date: (Required.)

1. Community Cleanup Organization Name: (Required.)

2. Name of Group Leader: (Required.)

3. Contact Information:

4. Event Date and Start Time (Required.)

5. Where did your cleanup take place?

6. How many hours did your group spend cleaning? (Required.)

7. How many volunteers were in your group? (Required.)

8. How many bags of trash did your group pick up? (Required.)

9. How many bags of recyclables did your group pick up?

10. How many miles of roadway did your group pick up?

11. How many acres of park land did your group pick up?

12. How many miles of rivers, waterways, and/or beaches did your group pick up?

13. How many miles of trails (hike and/or bike) did your group clean?

14. Did your group find any illegal dump sites? If so, where?

15. I hereby confirm that upon submitting of this form all the information above has been provided with the best of my knowledge on the following date: (Required.)