Beach Bingo Form

gift to Name

1. Name *

First

Last

2. Contact Information (phone number or email) *

3. Where did you cleanup litter? *

4. What date was your litter cleanup? *

5. How many people participated in your cleanup? *

6. How many bags did you collect?

7. What was the most common item you found?

8. Upload a picture of your completed beach bingo card to be entered to win one of three $50 grocery story gift cards. *

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

9. Upload pictures from your cleanup (items found, bags, etc.)

Drag & Drop Files, Choose Files to Upload

10. How did you hear about Beach Bingo? *