Operation Snow Shovel - Online Registration

Name:
Address:   City:
Postal Code:  Telephone:
Email:

Are you a: senior citizen person with disabilities other

Is a student required for the entire season? Yes No

Your needs are for: heavy snow falls only
ice storms only
heavy snow falls and ice storms
all snow falls and ice storms

Do you have any plans to be away between November and April? Yes No
If yes, when?

Is there a person we can contact in your absense? Yes No
Name:  
Phone:  

What areas would you like to have cleared of ice and snow?
(check all that apply) 		public sidewalk
driveway
front entrance, walk and steps
side entrance, walk and steps

Do you have snow removal equipment that the student can use? Yes No
If yes, please specify: