Registration for Growing Green With Pride Event - Saturday, May 4, 2019

Coordinator Name *	Position/Title *	Organization Name	Street Address *

City *	State *	Zip Code *	Phone Number (Work)

Phone Number (Home)	Phone Number (Cell)	Email Address *

I provide my permission to Prince George’s County, Maryland to publicize my organization name, contact number and email address on the web page for any interested
volunteers to join our group for this event. *

Yes No

Name of Streets to be Cleaned:*

Block Number		Name of Street
	_Hundred Block of_

Who owns the site(s)? *
State of Maryland	Prince George's County	M-NCPPC	PGCPS	Others

Do you have permission from the property owner or school principal to enhance the site? Yes No

From whom did you receive permission?
First Name	Last Name	Position	Phone Number	Email Address

Please request a letter of permission from the owner and have onsite the day of the event.

Volunteers participating in this cleanup*

Number of Volunters *	Bags of Mulch (max. 8) *


First Name	Last Name	Email Address	Attending Picnic	Shirt Size
			Yes No	S M L XL 2XL

Total Shirts

Small	Medium	Large	Extra Large	2XL
0	0	0	0	0