Submit Your clean-up event Event InformationEvent Type(Required) Litter Clean-up Community Beautification Education Recycling Other Other: Please SpecifyEvent Name(Required)Event Website Have you held this event before?(Required) Yes No, this is the first time How many times have you held this event?(Required)Estimated # of VolunteersGroup DetailsOrganizing Group / Organization Name(Required)Event Contact Person First Name First Last PhoneEmail Enter Email Confirm Email Organization Headquarters Street Address City ZIP / Postal Code When is Your EventStart Date(Required) MM slash DD slash YYYY StartTime(Required) Hours : Minutes AM PM AM/PM End Date(Required) MM slash DD slash YYYY End Time(Required) Hours : Minutes AM PM AM/PM Where is Your EventEvent Location(Required) Street Address City ZIP / Postal Code Is your event on any public use land (state park, state forest, wildlife area, local park, waterway, open public space)?(Required) Yes No Yes, Please Elaborate:(Required)Is this a private event? Yes No The New Mexico Department of Transportation has limited supplies available for clean-up events. Do you need supplies for your event such as trash bags and/or gloves?(Required) Yes No If your event is 3 weeks or later away, let us know if you’d like clean-up supplies that can contribute to your event, to include up to 50-33 lb. trash bags and 100 pairs of disposable gloves.Data is crucial to the success of the Breaking Bad Habits. Do you agree to complete the data collection form that will be sent to you, after your event, that will ask for information on number of participants, man hours worked, number of trash bags collected, etc..(Required) Yes, I will submit the data after my event No, I will not submit the data after my event Notes for your EventCAPTCHA
