"Never doubt that a small group of thoughtful, committed citizens
can change the world.  Indeed, it's the only thing that ever has."
                      
                      Margaret Mead
Clean-up Report Form
Name

Organization

Address




Phone Number




Date of pick-up

Number of volunteers

Number of total hours

Number of bags

Comment
If you have more than one entry, please list with a comma between
entries, i.e.  1/1/2008, 1/8/2008, 1/15/2008
Thank you for your efforts in keeping our environment clean and beautiful!