Fillable CLEAN COMMUNITIES GRANT APPLICATION (Borough of Merchantville)

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CLEAN COMMUNITIES GRANT APPLICATION (Borough of Merchantville)

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U.S.A. forms for Borough of Merchantville

BROWSE BOROUGH OF MERCHANTVILLE (NJ) FORMS

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CLEAN COMMUNITIES GRANT APPLICATION
Thank you for your interest in a Clean Communities Grant. One grant per month will be awarded.
Your organization should complete at least 2 hours of service and one adult per every 5 children
is required. Please complete the application below and return to Denise Brouse at Merchantville
Borough Hall in the Clerks Office.
Date ____________
Group/Organization ________________________________________
Contact/Leader__________________________ Phone __________________________
Address_____________________________________________
E-mail ______________________________________________
Clean up Date __________________________
Member Signatures
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
Please fill out this form and return to 1 W. Maple Avenue, Merchantville, NJ 08109
You pick a clean up date and the area your group would like to clean.
Groups must not have less than ten (10) people in the clean up.
Your group must have (1) adult for every (5) children.
All groups must sign and return the signature sheet and map.
Groups coming to clean up without proper supervision will not be able to
participate in the clean up.
Mail this form back A.S.A.P. First come, first serve.
Check drawn to:____________________________
Call me at 662-2474 ext. to schedule an appointment to pick up gloves, trash bags and signature
sheet for the cleanup.
________________________________________________________________________
Office use only
Confirmation Date: ________________
BOROUGH OF MERCHANTVILLE
CLEAN COMMUNITIES
INFORMATION
Group Name ____________________________ Clean up date___________________
Amount for clean up per group $200.00
1. Gloves, trash bags and maps may be picked up between 9:00-4:00 PM
Monday-Friday in the back office. If this time is not convenient,
please call 662.2474 ext 303 to arrange a pick up.
2. Groups must have at least ten (10) people and one (1) adult per five (5) youth.
Any group without proper supervision will not be able to participate in the clean
up.
3. List and sign all supervisors and youth participating in the clean up.
4. Mark on your map the area that your group did the clean up, the group name, date
of clean up and the amount of trash bags collected.
5. Place all trash bags together at the curb of the closet street.
6. Clean up time should not be less than one (1) hour.
7. List of names and the clean up map with the proper information must be returned
to the office before the check will be released.
Questions? Call Denise 662-2474 ext 303
SIGN IN SHEET
1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
4. ___________________________________________________________
5. ___________________________________________________________
6. ___________________________________________________________
7. ___________________________________________________________
8. ___________________________________________________________
9. ___________________________________________________________
10.___________________________________________________________
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CLEAN COMMUNITIES GRANT APPLICATION (Borough of Merchantville)

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Completed 23 January 2021

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