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2021 Citywide Clean Up Host Site Registration Form

  1. Information

    The City of Fridley is looking for residents, neighborhood groups, community organizations, and businesses to organize and host clean up locations as a part of the Citywide Clean Up. Organizations must be non-discriminatory and non-political. Please fill out this registration form if you are interested in organizing and hosting a clean up site. Please reach out to Alyssa Kruzel, Community Engagement Specialist, at Alyssa.Kruzel@FridleyMN.gov or at 763-572-3579 with any questions or concerns. 

  2. Type of Group: *
  3. (Park, Trail, Neighborhood, Rental or Housing Community, Street(s), Local Business, or we need help determining a location)

  4. Data Practices Consent
    • Filling out this form is entirely voluntary.
    • In this form, you are being asked to provide information about yourself which will be used by City Staff and that may be classified as “private data” under the Minnesota Government Data Practices Act. The purpose of this request for information is to register for the 2021 City of Fridley Citywide Clean Up. Your telephone number and email may be released by the City under certain circumstances such as when the City is required under state law or court order.
    • This form also asks you for information about yourself that is "public data” under the Minnesota Government Data Practices Act. Public data is maintained by the City and can be accessed by any person for any reason. For these reasons, you should only provide information that you are willing to share.  The City of Fridley complies with the Minnesota Government Data Practices Act.
  5. Consent agreement*

    Please check the box if you have read and agree to the Data Practices Consent statement.

  6. Leave This Blank:

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