HCCC Adopt-A-Spot Project Supplies Request Form

HCCC Adopt-A-Spot Project Supplies Request Form
Adopt-A-Spot Program volunteers help keep our city clean and beautiful. Volunteers clean an adopted spot five times a year for two years, and in return, receive city-wide recognition for their efforts. In addition, volunteers have access to cleanup equipment and supplies - you can order supplies on-line below!
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Organization Name
Project Site
Number of People
Planned Project Date

MonthDayYear
Date
Supply Request Information
Date to pick up supplies

MonthDayYear
Date
Pick up time

8am-12pm1-4pm
Number of Bags
Bag Sizes Requested

SmallMediumLargeExtra Large
Number of Small Bags Requested
Number of Medium Bags Requested
Number of Large Bags Requested
Number of Extra Large Bag's Requested
Number of Gloves
Glove Sizes Requested

SmallMediumLargeExtra Large
Number of Small Gloves Requested
Number of Medium Gloves Requested
Number of Large Gloves Requested
Number of Extra-Large Gloves Requested
Number of Litter Sticks
Number of Safety Vests
Number of Buckets
Limited Number Available
Number of Clicker Counters
Limited Number Available
Please be sure to separate used from unused vests and gloves; to untie/unknot all vest strings; and to refrain from folding up gloves that have been worn or are soiled.

If you have bags of trash needing to be picked up, please list the location of the bags on this form. If there are large items of trash/debris needing to be removed, call 757-727-1130. Please note that trash bags cannot be tied to poles/signage or placed at the base of such. The City's automated trucks must have access and enough clearance to pick up the bags. Place your bags as close to a public curb as possible without preventing foot/vehicle traffic.
Additional Comments
Should be Empty:

HCCC Adopt-A-Spot Project Supplies Request Form

Supply Request Information