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Application to participate in the Keep Little Rock Beautiful 2025 Great American City Wide Cleanup
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Email *
Name of Neighborhood, Organization or Business *
Are you enrolled in the Adopt-A-Street Program?
 *
Required
Name *
Phone *
Email *
City Ward # *
Required
Number of volunteers you expect:
 *
T-Shirt sizes for volunteers: Adult sizes only - list quantity desired (note no XXL or larger available)
Small
Medium
Large
Extra Large

NOTE: We are happy to provide t-shirts to volunteers, but please consider opting out or reducing the number of requested t-shirts to allow Keep Little Rock Beautiful to use sponsor funds to support other cleanup needs.

Cleanup needs (Quantity will be based on number of volunteers):

Please check supplies needed:

T-shirts, vests and other supplies may be limited.
Area that will be cleaned (be specific):
 *
Type of cleanup (litter, leaves, beautification, pruning, street cleanup, trails, park, etc.):
 *
A limited number of dumpsters are available – Do you need a dumpster?
 *
(The City now requires a Release of Liability Form for each location.)
Address for roll-off dumpster to be delivered:
Property Owner:
Contact Number:
How will you promote your cleanup to your NA, organization, & volunteers? (Facebook, newsletter, posters, phone, e-mail, flyers, banner, etc.)
 *

We understand the importance of providing feedback and reports to KLRB in return for receiving cleanup supplies. We will provide a follow-up report and volunteer sign in logs to KLRB within 5 days post cleanup. Failure to do so may prevent us from receiving supplies for future cleanups. 

Digital Signature:
 *
Date:
 *
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