Spring Clean Up / Pitch-in WeekGeneral Information Group Name – (This will be listed on the Spring Clean Up Map) Name First Name Last Name Address Mailing Address City/Town Province Postal Code Country - Select -AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta & MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d’IvoireDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorth MacedoniaNorwayOmanOutlying OceaniaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. HelenaSt. Kitts & NevisSt. LuciaSt. MartinSt. Pierre & MiquelonSt. Vincent & GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis & FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Primary Phone Number Email Address Information about your Organization / Group Number of people who will participate in your campaign Number of small bags required (grocery bag size) Number of large bags required Please select the category that best describes your organization/group Elementary / Secondary School College Daycare / Preschool Cubs / Scouts / Beavers / Ventures / Rovers Local Government Fish & Game Organization Chamber of Commerce Conservation Authority Seniors Group Women’s Institute Brownies / Guides / Pathfinders /Sparks Naturalist / Outdoor / Environmental Group Athletic Organization Residents / Ratepayers / Families Service Club / Community Group Youth Group Business Religious Organization Firefighter / Police / Public Safety Other Category that describes your organization Clean-up Information Please select the type of location where you will be organizing a clean-up event Schoolyard Neighbourhood Park / Playground Ravine Shoreline / Waterway Highway / Road Business Cemetery / Churchyard Wildlife / Conservation Area Trail Sports Field Other Specify the type of location where you will be organizing a clean-up event Date(s) of your Clean-up Project(s):Date(s) of your Clean-up Project(s): Date(s) of your Clean-up Project(s): Item weight Add more items more items Scope (length of time, special details) Please provide the start and finish addresses/street locations of your clean-up area. Be as accurate and detailed as possible as this information will be used for mapping out cleaning routes (Include Street numbers etc.). Start Address Finish Address Freedom of Information and Protection of PrivacyThe personal information on this form is collected by the City of Prince George for the purposes of processing this application, under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection of information, please contact the Manager, Parks and Solid Waste, at 1100 Patricia Boulevard, Prince George, BC, or by telephone 250-561-7600.Learn more information about the collection of personal information under the Freedom of Information and Protection of Privacy Act.All information collected in this application will also be shared with, processed, and stored by the Recycling & Environmental Action Planning Society (REAPS).
