Cleanup Supply Request

If you are planning a community cleanup and need supplies, please fill out the form below at least three weeks prior to your cleanup date.

Organization Name*
Contact Name*
First Last
Contact Phone*
Contact Email*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
County*
Date of Cleanup*
MM slash DD slash YYYY
Location of Cleanup*
Please describe the area of the cleanup:*
Expected Number of Volunteers / Participants*
Are you a current PalmettoPride Grant recipient?*
- Yes
- No
Check which supplies you need:*
- Bags
- Gloves
- Safety Vests
*No more than 250 qty per item.
Would you like to subscribe to PalmettoPride's monthly e-newsletter to learn of litter cleanups and other organization updates around SC?*
- Yes
- No, not at this time
- I'm already subscribed

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