2021 Adopt-A Program Report Form
Date of Trash Pickup
*
-
Month
-
Day
Year
Date Picker Icon
Group Name
*
Ex: Christopher and Maggie Holt, YAY Brunswick, etc.
Group Contact's Name
*
First Name
Last Name
Contact's Email
*
Number of Volunteers
*
Number of Hours Worked
*
Number of Bags of Litter
*
Number of Tires
*
My group disposed of my litter
*
YES
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
Upload ALL 2021 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!
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