Great American Cleanup
Productivity Report
Group or
Organization:
Date of Event:
Submitted By::
Phone Number:
Email
Address:
Name of
Adopt-A-Road:
Please Check All That Apply
School/Campus Cleanup
Roadside Cleanup
Railroad Cleanup
Church Cleanup
Inland Waterway Cleanup
Park Cleanup
Beach Cleanup
Off Shore Cleanup
Other
Hours Worked Per
Volunteer:
Number of
Volunteers:
Estimate Pounds of
Recycleables
Removed:
Number of Trash
Bags Filled
w/Recycleables:
Number of Trash
Bags Filled:
Estimate Pounds of
Litter Removed:
Number of Large
Items Found:
Approximate
Mileage of Cleanup
Number of Trees
Planted:
Number of Flowers
or Shrubs Planted:
Number of Bags of
Mulch:
Where were trash
bags left for pickup?
Description of Event