HomeDocuments, Reports & ProcurementsCommunity Clean Up Fund Request Form

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.

  • 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.
  • Please provide the street address or, if there is no street address, a geographic description of where the activity will take place.
  • Please describe in a few sentences the nature of the activity, and how it will benefit the community.
  • 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.
  • Accepted file types: doc, docx, xls, xlsx, pdf.
    Maximum file size - 1 mega bytes.
  • Estimated month and year of beginning of project and completion of project. Include separate phases if applicable.