Litter Bit Better Registration Form

Submitted by Rene Jones Lafflam on Wed, 2007-03-14 19:19.

During the week of April 18-26, 2009, volunteers from Rochester neighborhoods, businesses, groups, and individuals will be working together to pick up the litter in our community.

Will you join in the effort?

You can help by volunteering to pick up Rochester.

This would be a great service project for a company, department, club, service or faith group, sports team, or neighborhood. Either choose the area you'd like to clean-up or we can assign an area for you or your group, then pick a day during the week to pick it up!

LBB City Map
 
LBB Map Key
 

  1. Find a location on the map* and the corresponding number, that your group would like to adopt. The map of Rochester has been broken down into five separate maps that you can view here.

    *Maps are updated as time allows so please be understanding if your first choice is already chosen.

    Please contact Mike Kraszewski, Rochester Public Works Department, for additional information, by phone at 328-2431 or by email if you have further questions.

  2. Please complete the registration form below with information how you will help pick up Rochester.
  3. A representative from A Litter Bit Better will contact you within a couple of days with additional information.
  4. Information that you will be sent is included on our website that we ask you please read before your litter collection.

Privacy Policy: The Litter Bit Better partnership will only use the information you submit to help coordinate community clean up efforts. If you have any concerns or questions about information privacy, please contact Barb Huberty, Rochester Public Works Department, for additional information, by phone at 328-2425 or by email.


Optional: Your organization
*
Required: Your first name.
*
Required: Your last name.
*
Required: Your street address. We will be sending out "Thank You" notes after the cleanup week!

Optional: Apartment, Suite, or other address information.
*
Required: Your city.
*
Required: Your state (2-letter abreviation).
*
Required: Your zip code (5-digit or 9-digit).
*
Required: A phone number where we can reach you (please include area code).

Optional, but recommended: Please make sure that you enter your email address accurately!

Optional: Describe the area that you or your group would like to clean (specific block, neighborhood, park, waterway, etc.)

Preferred Cleanup Location Second Choice

Optional: Describe the date and time (between April 21-28) that you or your group would like to participate.

Optional: Estimate the number of volunteers in your cleanup group.

Optional: Describe other areas in Rochester, MN, that you think need to be cleaned up.

Magazine article, speaker, radio, television, website, poster, ect.