Clean-up Day Request Form

Donation/Large Item Trash Pick-up
Registration Form

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Need help moving? *

If you need assistance, volunteers will only be available between 8-10am on Sunday, 8/25

Donation Type *

Clothing Bedding Household Items & Collectables Small Kitchen Appliances & Electronics Furniture Mattress (must be wrapped in plastic)

Select all categories that apply

Detailed Donation Description *

Large Item Type *

Furniture Appliances Computers & Monitors Television Sets Tires (No Rims) Tree Branches/Yard Debris Other Oddly Sized Items

Detailed Large Item Pick-up Description *

Submit

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