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Bergen County Clean Communities Clean Up Mini-Grant Application

  1. Organization Information

  2. Please provide organization name as it would appear on grant check. Organization must be non-profit.

  3. Environmental group, school group, church group, scouting, etc.

  4. 123-456-7890

  5. Clean up Project Information

  6. Photographs can be provided but are not required


  8. *To be eligible for funding, the clean up site must be approved by the Bergen County Clean Communities Coordinator

  9. *Projects completed without approval will not be funded

  10. *The cleanup must consist of litter pickup. Tree planting or removal of vegetation cannot be substituted for litter collection

  11. *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

  12. *Keep track of the litter and recyclable material collected for the Summary Report

  13. *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.

  14. *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

  15. *Provide proof af adequate liability coverage

  16. *You must make arrangements for disposal of the material collected

  17. *Return all tools and un-used equipment borrowed from the Bergen County Clean Communities Program

  18. Leave This Blank:

  19. This field is not part of the form submission.