Community Clean Up Fund Request Form

All fields marked with an asterisk (*) must be completed for you to successfully submit this form. All sites under consideration for CCUF reimbursement must be located within Chittenden County. Requests may be submitted by anyone for cleanup on public or private property, but must be approved by the relevant CSWD Commissioner before CSWD can confirm availability of funds and release reimbursement. See the Community Cleanup Fund Page for complete guidelines and contacts.

CSWD member municipality requesting funds * Required
Please enter the Chittenden County town, city, or village where the project will take place.
Project Contact - Name * Required
The municipality’s CSWD Commissioner is the designated Community Cleanup Fund Contact and must approve the project. Please enter the name of the person requesting funds on behalf of the municipality if different from the Commissioner.
First Last
Project Contact - Email * Required
Project Contact - Phone * Required
Project location * Required
Please provide the street address or, if there is no street address, a geographic description of where the activity will take place.
Scope of cleanup * Required
Please describe in a few sentences the nature of the activity, and how it will benefit the community.
Estimated costs * Required
Please include as much detail as possible. If project has already been completed, please attach proof of paid expenses for which you are requesting reimbursement.
Upload supporting documents
Accepted file types: doc, docx, xls, xlsx, pdf, Max. file size: 1 MB.
Maximum file size - 1 mega bytes.
Estimated project timeline * Required
Estimated month and year of beginning of project and completion of project. Include separate phases if applicable.