Clean JXN Kick-Off Registration Form
The City of Jackson is proud to announce the kick off of The Let’s Go Clean JXN Campaign in conjunction with The Great American Clean Up on Saturday, March 16, 2019 from 9:00 a.m. until 2:00 p.m.

By submitting this form, you are indicating you wish to participate in The Let’s Go Clean JXN Campaign. You will be contacted with further details and instructions how you can be involved. If you have questions, contact Constituent Services at 601.960.1084.

Email address *
Registration Type *
Name *
Your answer
Phone Number *
Your answer
Group or Organization
If you are registering with a group, please enter the group organization's name here. If you're not with a group, you can leave this blank.
Your answer
Number of Volunteers (Approx.)
Your answer
Where do you want to clean? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service