2024 Adopt-A Program Report Form
Date of Trash Pickup
*
-
Month
-
Day
Year
Date Picker Icon
Organization's Name
*
Ex: Christopher and Maggie Holt, YAY Brunswick, etc.
Site Leader's Name
*
First Name
Last Name
Contact's Email
*
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
*
YES
NO (if no, list cross street where bags are placed, below, in "Other")
Other
Number of Bags of Recycling Collected
My group picks up cigarette butts?
If Yes, How many?
Upload ALL 2022 VOLUNTEER SIGNATURES HERE
Upload a File
We must have on file signatures of ALL volunteers for your group each year.
Cancel
of
Submit favorite cleanup photo here.
Find us (and your uploaded photos) on our social media pages!
Submit
Should be Empty: