Summer Enviromobile Registration | Lake County Solid Waste Management

8695 Broadway, Merrillville, IN 46410
(219) 853-2420

Summer Enviromobile Registration Form

Contact Name *

Email Address *

Group Name *

Address (program location) *

City / State *

Grade Level *

# of Students *

Phone Number *

Number of Sessions (maximum of 20 students per session): *

Please provide three (3) possible dates for your program. Scheduling is on a first come, first served basis.

(June, July, and August dates only. To register for a school year program, please use the Enviromobile Registration form).

1^st Date Choice *

2^nd Date Choice *

3^rd Date Choice *

To assist in scheduling, please list:

Earliest Start Time *

Lunch Time