Adopt-A-Spot Wrap Up Report
Adopt-A-Spot Information
Adopt-A-Spot Recognition Name
*
The name on your AAS sign.
No. of Volunteers
*
Cleanup Date
*
-
Month
-
Day
Year
Date
Adopt-A-Spot Location
*
Name of Street & Major Intersections
Cleaup Start Time
*
Hour Minutes
AM
PM
AM/PM Option
Cleanup End Time
*
Hour Minutes
AM
PM
AM/PM Option
Cleanup Hours
Total Volunteer Hours
Results Report
No. of 13-Gal Trash Bags Filled
*
Type of Litter Collected
*
Aluminum Cans
Cardboard
Cigarette Butts
Clothing/Bedding
Diapers
Fast Food Packaging
Glass Bottles
Paper/Receipts
Plastic Bags
Plastic Bottles
Tires/Tire Scraps
Select all that apply.
No. of Vape Cartridges/Cases
*
No. of Cigarette Butts
*
Most Frequently Collected Item
*
Please Select
Aluminum Cans
Cardboard
Cigarette Butts
Clothing/Bedding
Diapers
Fast Food Packaging
Glass Bottles
Paper/Receipts
Plastic Bags
Plastic Bottles
Tires/Tire Scraps
Please select only one from the list.
Most Unique/Unusual Item Collected
Upload Photos
Browse Files
Drag and drop files here
Choose a file
Consider: Photos of litter. Before/After photos. Photos of your group.
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Submitter Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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