Supply Pick-up Request Form

Supply Pick-up Request Form

Parks & Recreation
This form is to inform our staff of your need for supplies. Please submit at least five business days prior to a clean-up.

Supplies can be picked up from 8 am to 5 pm Monday through Friday at the Parks and Recreation Administration Building, located at 301 S. Greene St., Suite 300, Greensboro, NC 27401. If you are picking up safety vests, you will be asked to sign them out as well as return them within a week of your scheduled clean-up.

Anyone who submits a form should be aware that in accordance with the North Carolina Public Records law, found in North Carolina General Statutes Chapter 132, their e-mail address is considered public record.
Name of organization*
Adopted Street, Park, or Trail*

Name of Street, Park or Trail

Street Address Line 2

CityState

Zip Code
Name of group representative*
Clean-up date*

MonthDayYear
Date
Preferred method of contact*

PhoneE-mail
Email
example@example.com
Phone number

Area CodePhone Number
Anticipated number of participants*
I need to pick up*

Trash bagsGlovesSafety vestsGrabbers
Comments
Please provide the date you plan to arrive so materials can be ready for pick-up*

MonthDayYear
Date
Should be Empty: