KHB Site Box Score Form

* Indicates required field

Organization *

Site Name *

Submitted by *

First

Last

Phone Number *

Email *

Cleanup Date *

Council District *

Event start time *

Event end time *

Choose Any *

Cleanup Beautification

Number of volunteers *

Number of Probationers *

List the name of each participating volunteer group:

Volunteer Group 1. *

Voluneer Group 2. *

Volunteer Group 3. *

Volunteer Group 4. *

Volunteer Group 5. *

Volunteer Group 6 *

Please provide address (s) of lots mowed:

Address 1 *

Address 2 *

Address 3 *

Address 4 *

Other *

ACTIVITES: Please indiciate the quantities for the activities completed.

Trash Bags Collected *

Esplandes Mowed *

Street Blocks Cleaned *

Esplandes Cleaned *

Illegal Dumps Cleaned *

Ditches Cleaned *

Vacant Lots Cleaned *

Parks Cleaned *

Car Tires Collected *

Truck Tires Collected *

Recycling Bags Collected (glass, plastic, aluminum cans) *

Pounds of electronics collected for recycling *

Dumpsters Filled *

Lots Mowed *

Miles of hiking, biking, nature trails cleaned/weeded/maintained *

Playgrounds/sport fields, community recreation areas built, cleaned, restored, constructed *

Nature centers, outdoor classroom areas built, cleaned, restored, constructed *

Homes painted, renovated, built *

Flowerbeds/Gardens Installed *

Individual Plants/Flowers Planted *

Trees Planted *

Street Esplanades Landscaped *

Waterways cleaned, restored, improved *

Graffiti Sites Removed *

Submit