Shelton Litter Cleanup Reporting Form
This is a volunteer reporting form for any group or individual who has picked up litter in Shelton, CT, including Adopt-a-Street and Clean Sweep participants as well as anyone else who has picked up litter in a public place. While completion of this form is not required, we do encourage our volunteers to record their efforts. This gives us a better idea of how many people are involved and how much is getting picked up. It also inspires other people to clean up their neighborhood. Thank you! Note: For Clean Sweep patches and certificates, you also need to fill out a second form. See the Clean Sweep webpage at
Name *
Of group or individual who did the cleanup. Shy volunteers can enter "anonymous.'
Contact Name
For groups only
Location Cleaned *
This should be a public place, such as a street, park, school, or waterway. If doing a road, please specify the road section you actually cleaned.
Date(s) of the cleanup *
Please estimate how much was picked up. *
(Example: "7 large bags and a TV."
How many people participated in your cleanup? *
This helps us estimate the number of people involved throughout the city.
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