CLIP - Community Service Program request form

Your contact information

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

ZIP Code

Primary phone number*

Secondary phone number

Email*

Number of volunteers*

Minimum of 3

Location

Block Alleyway Lot Underpass Overpass

Please describe the location(s)

Location address

Address Line 1

Address Line 2

City

State

ZIP Code

If you're cleaning up an alleyway between two streets, what are those streets?

Is the alleyway locked?

Yes No

Do you have a key?

Yes No

Please list the types of debris at the location(s):

Assure alleyway is unlocked on day of clean up.
Make neighbors aware of clean up.
If you are requesting the clean up you must hand out literature and confirm residents' participation.
Make parking available in front of cleanup location or alleyway for city vehicles.

We will only assist you with alleyway cleanups one time.