Activity Summary Form Contact 614-645-8047
After each event please fill out this activity summary form. Remember to submit the form within 48 hours after your event ends.
Event organizer:
Cleanup Area:
Contact Email:
Date of Service: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2008 2007 2010 2011
Activity: Litter Clean-Up Graffiti Abatement Beautification
Number of Participants:
Start Time: 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 12:00 12:30 AM PM
End Time: 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 12:00 12:30 AM PM
Please fill in the pertinent information below for your event.
Approximate number of garbage bags filled: Miles of streets/roads/highways cleaned: Miles of hiking/biking/nature trails cleaned: Acres of parks cleaned: Number of trees planted: Number of graffiti sites removed/abated: Square feet of graffiti tag: Number of tires collected for recycling:
