Bergen County Clean Communities Clean Up Mini-Grant ApplicationHome / Bergen County Clean Communities Clean Up Mini-Grant Application Name of Organization(Required)Enter the name of your organizationType of Organization(Required)Enter type of your organizationStreet Address(Required)Enter your street addressMunicipality(Required)Enter your municipalityState(Required)Enter your stateZIP Code(Required)Enter your zip codeContact Person(Required)Enter the name of the contact personContact Phone(Required)Enter contact’s phone numberContact Email(Required) Enter contact’s email addressLocation of Proposed Cleanup Site(Required)Enter the location of the proposed cleanup siteMunicipality(Required)Enter cleanup site municipalityProposed Cleanup Date(Required)Enter proposed cleanup datePlease Describe Litter Problems At The Site(Required)Please describe the litter issues observed at the siteFAILURE TO ABIDE BY ANY OF THE FOLLOWING CRITERIA WILL INVALIDATE APPLICATION AGREEMENT *To be eligible for funding, the clean up site must be approved by the Bergen County Clean Communities Coordinator *Projects completed without approval will not be funded *The cleanup must consist of litter pickup. Tree planting or removal of vegetation cannot be substituted for litter collection *Follow the Safety Guidelines provided on the website and ensure adult supervision to the ratio of 1 adult to 5 children under the age of 16 *Keep track of the litter and recyclable material collected for the Summary Report *Photographs must be provided of the garbage collected and participants in the act of collecting the garbage. Digital photos are preferred and can be submitted through E-mail, CD or USB Drive. *Indemnify and hold harmless the County of Bergen and its employees from any accidents or injuries to persons or property resulting either directly or indirectly from participation in the Project *Provide proof af adequate liability coverage *You must make arrangements for disposal of the material collected< *Return all tools and un-used equipment borrowed from the Bergen County Clean Communities Program CAPTCHAComplete the verification to confirm you’re a human and continue.