2. The Coconino County Community Development is planning a clean-a-stream event in May 2016. The clean-up location is not determined, but it will be within a 20-minute drive from downtown Flagstaff. The purpose of this survey is to elicit feedback from volunteers to determine the best date and time for the clean-a-stream event.
4. Which time of day do you prefer?

   1. 9:00 AM – 11:00 AM

   1. 4:00 PM – 6:00 PM
6. Do you prefer a weekday or weekend?

   1. weekday

   1. weekend
8. Please Select your first, second and third preferred clean-a-stream dates:
10. First preferred date:
    First preferred date:
11. Second preferred date:
    Second preferred date:
12. Third preferred date:
    Third preferred date:
14. My Contact Information
16. Last Name:
17. First Name:
19. Street Address:
21. City:
22. State:
23. Zip Code:
25. Email Address:
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field