2. Pick It UP! Campaign
   Pledge Form

4. District 4 Pick It UP! Campaign Pledge

   I pledge to help keep Council District 4 clean by not littering anything, anytime, or anywhere. Instead, I will safely and properly dispose of my trash in a waste basket, recycling bin or compost container.  I will also commit to keeping the areas around my home and workplace litter free and encourage others to do the same. By taking this pledge, I understand that we all must do our part to preserve Council District 4 beautiful neighborhoods and roadways.

6. 
8. First Name
9. Last Name
11. Address
13. City
14. State
15. Zip Code
17. Phone Number
18. Email Address
20. Tell us how you will commit to the District 4 #PickItUP! Campaign Pledge?
22. Shirt Size
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28. 1. Receive an email copy of this form.
29. Email address

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30. Submit

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