Volunteer Activity Reports
Which program do you volunteer with?
Adopt a Street/Keep Port St. Lucie Beautiful
Naturally PSL/Adopt a Park
Love Your Block
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Volunteer Activity Report
Group Name
*
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of clean-up
*
-
Month
-
Day
Year
Date
Number of Miles/Name of the Space adopted
*
Number of volunteers:
*
Number of volunteer hours (number of volunteers x hours):
*
Trash removed (number of bags )
*
Do you need assistance with removing the litter/debris your group collected? .
*
Yes
No
Please specify the location
*
Would you like to report any large debris or illegal dumping?
*
Yes
No
Please specify the location
*
Please List the items
*
Would you like to report any non-emergency maintenance requests?
*
Yes
No
What type of repair needs to be made?
*
Pothole
Signage removal/repair
Tall grass - mowing
Low hanging cables
Domestic animal
Wild animal
Damaged pet waste station/garbage can/benches
Other
Describe the amenities and the conditions of the item requiring repairs
*
Did you conduct any activities other than litter removal?
*
Yes
No
Describe your activities
Community Gardening
New Furnishing (benches, swings,etc)
Exotic plant removals
Other
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Volunteer Activity Report
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Number of hours volunteered
*
Trash removed (in lbs)
Grounds Cleaned (in acres)
Graffiti Removed (sq. ft.)
Trees Planted
Is this tied to a mini-grant award?
*
Yes
No
Features added
Repairs Completed
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General Comments
Please attach any photos of your group and/or any other photos of your findings. We are permitted to use any submitted photo for promotional purposes.
Attach images (10 max)
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