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2. Complete this form to request equipment and notify the City of Oak Harbor Public Works Department about your litter clean-up details. Please review the Pick up Street Litter Program page.

4. Date of Litter Collection*
   Date of Litter Collection

   Date of Litter Collection

   Must be three business days after this form is submitted.

6. Name of Street for Litter Collection*
8. Name of Organization / Individual Volunteering*
10. Phone Number of Organization / Individual Volunteering
11. Email for Organization Contact / Individual
13. Address of Organization / Individual Volunteering
Leave This Blank:


15. 1. Receive an email copy of this form.
16. Email address

    This field is not part of the form submission.

17. Submit

* indicates a required field