Clean Up Evaluation Form

Thank you so much for organising a clean up in your local community. Keeping New Zealand beautiful is a mammoth job and we couldn't do it without you!

We request all groups to fill in an evaluation form and submit it to Keep New Zealand Beautiful within 10 working days of their clean up event. The evaluation form will only take a couple of minutes of your time and the data you provide helps us calculate crucial statistics regarding community clean ups, and how we can best further support your efforts.

Supervisor - First Name

Last Name

Email Address

Group/Organisation

Site Address

Post code

Total of Volunteers

Total volunteer time (number of hours x number of volunteers)

Date of clean up

Did an accident/incident occur? If yes, please complete an incident report found in the link below.

Yes

To download the Incident report click here then email back to programmes@knzb.org.nz or post to PO Box 58932 Botany, Auckland

Were any cigarette butts found at your site?

Yes

If yes, approximately how many?

Were any disposable coffee cups found on your site?

Yes

If yes, approximately how many?

Does this site attract illegal dumping?

Yes

If yes, please describe what was found and where

Total number of rubbish bags collected

Total number of recycling bags filled

Estimated total site area in square metres (Handy hint: The average size of a rugby field is 6900 sqm)

Approximate weight of total rubbish collected

Any interesting or unusual items collected?

We would love to see your photos from the day! By uploading these your consent is given to use these images.

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.