Rise Form

Are you a R.I.S.E member?*
YesNo

Location Name*
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Location Type*
BeachesNon-recreational Coastal AreaInland ParksPublic Housing EstatesHawker CentresPlaygroundRetail Areas / Commercial AreasOthers
Waste Size*

Plastic Bags LargeModerateSmallNone
Plastic bottles, containers & packaging LargeModerateSmallNone
Other plastic objects (straws, cutlery, toys, pens, etc) LargeModerateSmallNone
Cigarette butts LargeModerateSmallNone
Paper tissue & small items (receipts, torn pieces, etc) LargeModerateSmallNone
Paper containers & boxes LargeModerateSmallNone
Flyers LargeModerateSmallNone
Other paper (newspaper, magazines, envelopes, etc) LargeModerateSmallNone
Styrofoam objects (boxes, plates) LargeModerateSmallNone
Glass objects (bottles, cups, bulbs, etc) LargeModerateSmallNone
Metal objects (cans, tongs, etc) LargeModerateSmallNone
E-waste (mobile phones, screens, batteries, etc) LargeModerateSmallNone
Others LargeModerateSmallNone

Description and Quantification of Litter

Type of bags used*

Number of bags collected*

Overview of the amount collected

Estimated weight of bags* (KG)

Number of other objects collected and unable to bag*

What were the "other" objects?* (e.g. oil drums, jerry cans)

Estimate the number of each type of item (specify minimum top 3 items)

Overall Number of Items
Plastic bags
Plastic bottles, containers & packaging
Other plastic objects (straws, cutlery, toys, pens, etc
Cigarette butts
Paper tissue & small items (receipts, torn pieces, etc)
Paper containers & boxes
Flyers
Other paper (newspaper, magazines, envelopes, etc)
Styrofoam objects (boxes, plates)
Glass objects (bottles, cups, bulbs, etc)
Metal objects (cans, tongs, etc)
E-waste (mobile phones, screens, batteries, etc)
Other (as specified above)

Photos

Photo BEFORE the cleanup
Photo DURING the cleanup
Photo AFTER the cleanup
Group Photo with Collected Trash

By this submission, I consent to the use of the above information and photographs for R.I.S.E.’s and the Public Hygiene Council’s publications and publicity materials, including websites and social media.

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