CLEAN UP KIT REQUEST

Before you fill out this form please ensure that you have read our Terms and Conditions and ensure that you have read and understood them.

First Name

Last Name

Name of Organisation (if applicable)

Address to send kit to (Please note we cannot send to PO Boxes)

Post code

Email address

Contact Phone Number

Number of Volunteers (estimate)

Location address of clean up

Date of clean up

Type of site of cleanup

Beach/coastal

Roads/highway

Parks/reserves

River/lake/creek

School grounds

Shops/malls

Other

Size of area of clean up (approximate sq.m)

Number of rubbish bags requested

Number recycling bags requested

Total pairs of gloves requested

Pairs of Small gloves

Pairs of Medium gloves

Pairs of Large gloves

Pairs of Extra Large gloves

How many people in the community will this clean up positively affect?

In return for receiving these resources free of charge we require all groups to fill in an evaluation form and submit it to Keep New Zealand Beautiful within 10 working days of their event. You will be provided with an evaluation link which you can fill in online. The evaluation form includes a few questions about the type of rubbish you have collected, an approximate weight of the collected rubbish and asks you to upload a few images.

Click here to view evaluation link so you know what types of information we need!

I agree to submit an evaluation form

I have read, understand and accept the Terms and Conditions

Yes

CLEAN UP KIT REQUEST

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