Form Center

2. Green Bucket Brigade Report Form
   Thank you for serving your community through the City of Norfolk’s Green Bucket Brigade, an invaluable part of our City’s litter reduction and prevention efforts! Please submit these reports quarterly to KNB.
4. First Name*
5. Last Name*
6. Email*
7. Phone*
9. Cleanup Location*
10. Date of Cleanup*
    Date of Cleanup
12. Green Bucket Number*
13. Number of FULL white bags*
15. Number of volunteers*
16. Number of youth (under 18)*
17. Length of Cleanup*
    Round to the nearest half hour.
19. Comments
21. Signature*
    I reviewed the safety guidelines with all volunteers.
22. Date*
    Date
24. *FOR COLLECTION OF YOUR BAGGED TRASH AND BULK DEBRIS, CALL 441-1347 IMMEDIATELY AFTER YOUR CLEANUP. PROVIDE US WITH UP TO TWO SPECIFIC LOCATIONS (ADDRESS(S) OR INTERSECTION(S)). OK TO LEAVE MESSAGE
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field