Use dashes: xxx-xxx-xxxx
Name of group or organization
Line 1: Street Address;
Line 2: City, State, Zip
*Must be in Scott or Rock Island County
Anticipated number of volunteers
Check all that apply. Supply quantities will be based on number of volunteers.
Between 8:30am–4:00pm weekdays.
Between 8:30am–4:00pm weekdays
Leave blank if you're planning to put the trash collected in your home garbage.
Please enter more details of your request. If none, enter "N/A". A member of our staff will respond as soon as possible.