Awards Dinner – Gwinnett Clean & Beautiful

Awards Dinner

YOU’RE INVITED

…To join Gwinnett Clean and Beautiful as we boldly go where NO ONE HAS GONE BEFORE! Treking to be the galaxy’s GREENEST AND CLEANEST community!

DATE:
Friday, January 6, 2012

TIME:
6-7pm: Social time, 7-9pm: Awards Dinner

LOCATION:
Atlanta Marriott Gwinnett Place

BUSINESS ATTIRE
$90 per person or
$1500 Event Sporsor
(premier seating for 10)

Please respond by December 15, 2011

Program - Adopt-A-Road Post Cleanup

Please complete this form as soon as your Adopt-A-Road group finishes a cleanup.

Adopt-A-Road Contact Information

Group Name

Contact Name(Required)

First Last

Address

Street Address Address Line 2 City ZIP / Postal Code

Best Phone #

Email(Required)

Post Cleanup Report Details

Date of Cleanup(Required)

Location of Cleanup(Required)

# of Bags of Garbage Collected(Required)

# of Illegal Signs Collected(Required)

Approximate Weight of Garbage (20lbs/bag)

# of Volunteers(Required)

# of Hours Worked(Required)

Do you need a DOT pickup?

If you are requesting a DOT pick-up, please make sure that all of the following apply. If not, please move the bags or items as requested below so that they can be collected.(Required)

Are the bags within the right-of-way (area between the street and the utility poles)?

Are the bags at an intersection of two roads that you can give for directions?

Are the bags placed together in an easily visible location?

If you are requesting a DOT pickup, please provide the cross streets of the intersection where the bags/signs were left.(Required)

How would you improve the Adopt-A-Road program?

Any other comments/suggestions?

Photo Upload

Max. file size: 256 MB.

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Email

This field is for validation purposes and should be left unchanged.

Contact

446 W. Crogan Street, Ste. 430
Lawrenceville, GA 30046

Phone: (770) 822-5187
Fax: (770) 822-5179
gwinnettcb@gwinnettcb.org

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2011-2022 Gwinnett Clean and Beautiful.

Designed By

Post Project Results Form

For Great American Cleanup

Contact Information

Project Leader Name(Required)

First Last

Organization/ Group Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email(Required)

Results

Describe the impact of your project below, or attach additional files if needed.

Project Category (pick one)(Required)

Project Date

Project Location

Project Description(Required)

Describe the work that was completed and the feedback you received from your volunteers and the members of the community.

# of Volunteers(Required)

This includes anyone donating their time to work on this project.

# of Volunteer Hours(Required)

This includes the total number of hours volunteered per person (example: 5 volunteers work for 2 hours = 10 Volunteer Hours)

# of Bags of Litter Collected

# of Miles of Road/Stream Cleaned

# of Trees/ Flowers Planted

# of Bags of Yard Debris Cleaned

Upload Photos

Show us your impactful work! Please upload 1-3 "after photos."

File(Required)

Max. file size: 256 MB.

File

Max. file size: 256 MB.

File

Max. file size: 256 MB.

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Dial-a-Dumpster

Name(Required)

First Last

Group/Organization Name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Please give a potential date for when you'd like to complete your event(Required)

Date should be at least 10 business days from today's date.

What type of location do you wish to cleanup with Dial-a-dumpster?(Required)

Business area

Neighborhood communal area

Park area

Other

If other, please describe.

Please describe where in your community you wish to cleanup, what types of items or materials need to be removed, and how this will benefit your neighborhood or business.(Required)

File

Max. file size: 256 MB.

Give an estimate of how many people will be participating.(Required)

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Groom and Bloom

Name(Required)

First Last

Group/Organization Name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Please give a potential date for when you'd like to complete your event(Required)

Date should be at least 10 business days from today's date.

What type of location do you wish to beautify?(Required)

Business entrance

Neighborhood entrance

School

Other

If other, please describe.

Please describe why you wish to pretty-up this place, what types of plants are being requested, and where they will go.(Required)

What gardening tools are needed to complete the project that you and your team do not already have?

Give an estimate of how many people will be participating.(Required)

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Litter League

Name(Required)

First Last

Group/Organization Name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Please give a potential date for when you'd like to complete your cleanup

Date should be at least 10 business days from today's date.

Please choose what type of cleanup you are most interested in doing

Road Cleanup

Stream/ Waterway Cleanup

Both

Do you have a location in mind for your cleanup?(Required)

Yes

No, I need help selecting one.

If yes, please provide an address or the nearest intersection to the location.

Give an estimate of how many people will be participating.(Required)

Do you have a certain number of hours you are wanting to work?

CAPTCHA

X