Bitter for Litter Trash Submittal

2. 

3. Bitter for Litter Trash Submittal

   The City challenges all residents and businesses to pick up one millions pieces of trash.

   The City challenges all residents and businesses to pick up one millions pieces of trash.

5. How many pieces of trash did you collect?*

   Estimate if you are unsure of the exact amount

6. Did you take part in an organized collection?

   1. NO
   2. YES

7. If YES, with which organization?

8. If YES, on what date?
   If YES, on what date?

10. 

11. If available, would you like a promotional t-shirt?

    1. NO
    2. YES

    You will be contacted by City staff on availability due to limited supply. If available, shirts may be picked up at the Cedar Hill Government Center.

12. If YES, what is your preferred size?

13. If your preferred size is not available, what is your second choice?

15. Name*

16. Email

    Required if requesting a t-shirt.

17. Phone Number

    Required if requesting a t-shirt.

19. School Name

    Required for School Challenge

20. Grade Level

    Required for School Challenge

21. Teacher

    Required for School Challenge

23. Photo Upload (optional)

    Upload a photo of your litter pickup

24. Photo Upload (optional)

    Upload a photo of your litter pickup

25. Photo Upload (optional)

    Upload a photo of your litter pickup

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field