2. *If your group does NOT dispose of the bags of trash and/or recyclable materials that were collected, you MUST submit a report and provide the location where the bags were left behind so that KACCB can make arrangements to have them hauled away.*
4. Group Name:*
6. Contact Name (in case there is a question regarding the location of the bags):*
8. Contact Phone Number:*
10. Contact Email Address:*
12. Date your group's clean-up took place (month/day/year):*
14. Number of bags of trash collected:*
15. Number of bags of recyclable materials collected:*
17. Number of volunteers under the age of 18:
18. Total number of volunteers:*
20. Amount of time volunteered:*
22. Do you need KACCB to arrange to have the bags of trash and recyclable materials that you collected hauled away?*

    1. Yes
    2. No
23. If hauling is needed, please provide a PRECISE, GPS-searchable, location where the bags were left behind (address, name of road, closest intersection, etc.) so that KACCB can dispatch a collections crew to pick them up. Vague information will cause delays.
25. Photo of your clean-up
    We'd love to give your group a shout out on social media. Please share some photos of your group in action!
26. Photo of trash and recyclable materials
    Take a snap of all the bags of trash and recyclable materials that your group collected!
28. Photo of stranger things
    Did your group find something odd, unusual, or out-of-the-ordinary that you want to share? Take a picture of it!
29. Photo of location (if address is not available)
    If there's no address or easy way to report the location where your group left the bags that need to be hauled away, please take a photo of the area so that we know what to look for.
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field