2022 Adopt-A Program Report Form
Date of Trash Pickup
Date Picker Icon
Ex: Christopher and Maggie Holt, YAY Brunswick, etc.
Site Leader's Name
Number of Adult Volunteers
Number of Youth Volunteers
How many hours did the clean up last?
Number of Bags Filled
Number of Tires Collected
My group disposed of my litter
NO (if no, list cross street where bags are placed, below, in "Other")
Number of Bags of Recycling Collected
My group picks up cigarette butts?
If Yes, How many?
Upload ALL 2022 VOLUNTEER SIGNATURES HERE
We must have on file signatures of ALL volunteers for your group each year.
Submit favorite cleanup photo here.
Find us (and your uploaded photos) on our social media pages!
Should be Empty:
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