Subscribe to a clean clean-up event

I want to organize a cleanup

I want to participate in a cleanup

Name of event

Name of group or business

Partner(s)

Location or address of cleanup *

Borough

Date *

Année

Mois

Jour

Start time

:

am

pm

End time

:

am

pm

Number of participants *

Number of women's T-shirts

Number of men's T-shirts

Contact person *

Address

Postal code

A9A 9A9

Daytime phone number *

(format xxx xxx-xxxx)

Extension

Cell

(format xxx xxx-xxxx)

E-mail *

I would like my cleanup to be listed on the Web site

CONFIRMATION: I have read and understood the information in the Security and Confidentiality section and I agree to send the data in the present form electronically

Note: This information will remain confidential and will be used to keep track of your activity during the current cleanliness campaign.

In case of inclement weather *

Date postpone *

Année

Mois

Jour

Start time postpone

:

am

pm

End time postpone

:

am

pm