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Love Your Neighborhood Report Form
Thank you for participating in the Love Your Neighborhood program with Keep Riverside Clean and Beautiful! Please submit your results below.
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* Required
Family/Group Name
*
Your answer
Name of Primary Contact
*
Your answer
Contact Phone Number
*
Your answer
E-mail Address
*
Your answer
Date of Cleanup
*
MM
/
DD
/
YYYY
Location of Cleanup
*
Please include zip code. Example: Neighborhood at Victoria Ave. & Jefferson St., 92504
Your answer
Did you borrow tools from KRCB?
*
Choose
Yes
No
# Volunteers
*
Your answer
# Hours each volunteer worked
*
Your answer
# Trash bags collected
*
Your answer
# Streets
*
Your answer
# Storm Drains cleaned
Your answer
# Tumbleweeds removed
Your answer
# Palm fronds removed
Your answer
# Green waste bags
Your answer
# Illegal Signs/Poles/Etc. eradicated
Your answer
# Graffiti tags removed
Your answer
Please list any bulky items collected and the amount (such as furniture, appliances, tires, etc.)
Example: Shopping cart (1), Tires (5), Mattress (1)
Your answer
Notes/comments to KRCB staff
3985 University Ave. Riverside, CA 92501 • 951.683.7100 x204 •
ssilva@riverside-chamber.com
•
www.krcb.com
Your answer
Thank you!
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