Publicity Awareness/Notification Flyer
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DUMP NO WASTEDRAINS TO OUR MISSISSIPPI We will be stenciling "Dump No Waste, Drains
to Our Mississippi" on the street near storm drains in this neighborhood:
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STORM DRAIN STENCILING REGISTRATIONName: ____________________________ Date: __________ Co-leader: ___________________ Organization: _______________________ Address: _______________________________ City: ___________________ State: ___________ Zip: ______________ Phone: _______________ FAX: ______________ County: _______________ Where do you plan to stencil? _________________________ How many drains will you stencil? ________ Who will be your volunteers? _____________________ Do you plan to work with another organization? O Yes O No Who? _________________________________ Notes:
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STORM SEWER STENCILING REPORTName: ___________________ Organization: ___________________ Address:__________________ Citv: ______________ State:______ Zip:_________ Phone: (____) ____-_______ County:
__________________ School: Youth Group: Adult O grades K-5 O ages 5-10 O (please describe) O grades 6-8 O ages 11-14 _________________________ O grades 9-12 O ages 15-18 _________________________ Date of stenciIing project: _________________ How many drains did you stencil? ___________ Where did you stencil? ____________________ Please send photocopies, photos, newspaper clippings or any other information about your stenciling project!
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