2019 Signup Form for Site Captains-- International Coastal Cleanup in Virginia
The 2019 Virginia Waterways Cleanup is part of the Ocean Conservancy's International Coastal Cleanup (ICC)! All ICC events in Virginia are coordinated by Clean Virginia Waterways of Longwood University. Please sign up your group today using this form and join the global effort to have trash free seas!

ICC events in Virginia can be held on ANY date between late August and early November. Mostly, they are held in September and October. If you have several sites, you can register just once, then send an email to cleanva@longwood.edu with a list of all of your sites. Be sure to let us know if your sites are open to the public, or if they are "closed" for a private group.

Questions? Please call 434-395-2602 or send an email to cleanva@longwood.edu. Thank you for making our world cleaner!
Last Name *
Your answer
First Name *
Your answer
Name of organization (or school, park, business) *
Your answer
Shipping Address, Line 1 (We ship via UPS, so no P.O. Box addresses.) *
Your answer
Shipping Address, Line 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Cleanup Site Name *
Your answer
County (or incorporated town) *
Your answer
Date of Cleanup (if known)
MM
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DD
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YYYY
Start Time (if known)
Time
:
End Time (if known)
Time
:
Is your cleanup event open to all interested volunteers? *
Required
Contact Email for CVW to use to contact you. *
Your answer
Your phone number for CVW to contact you. (Optional)
Your answer
If your cleanup is open to the public, which phone number and which email address should CVW post on its website?
Phone number:
Your answer
Email address :
Your answer
Provide special instructions about your cleanup.
This paragraph will be placed on CVW's web page so volunteers can learn about your cleanup event. Include: where to meet, what to bring, your website address, other details, etc. *
Your answer
Number of volunteers estimated at your Cleanup Site. If unknown, please type "will let you know later." *
Your answer
Which best describes your cleanup site? *
Required
CLEAN SWELL (The app for smart phones)
Clean Virginia Waterways encourages your volunteers to use the CLEAN SWELL app to collect data. It is especially good for individuals or small group use. Please download this FREE app onto your smart phone or tablet, and try it out. CVW is encouraging our Site Captains to use the Clean Swell app again this fall for all or part of your cleanup data. But we are more than happy to send you the good old paper "Marine Debris Data Forms"! As long as we get data from your volunteers about the types and quantities of trash the are finding, we are HAPPY!!
Will you use the new Clean Swell app to collect ICC data this fall? *
Required
On the next page, you will enter your supply needs.
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