Adopt-a-Highway Cleanup Report Form

Home Adopt-a-Highway Cleanup Report Form

Group Name*
Group Leader or Contact Person*
First Last
County*
Phone*
Email*
Section of Road Cleaned*
Name of road(s) and/or Beginning and Ending Mile Points
Date Cleaned*
MM slash DD slash YYYY
Total Number of Hours Worked*
Total Miles Cleaned*
Total Number of Volunteers*
The total number of volunteers that assisted with this particular cleanup.
Total Bags Filled*
Total Weight of the Bags*
Did your group complete a safety meeting before your cleanup began?*
Did your group separate the recyclables from the littered items?*
Other notes from your cleanup
Please list any comments or concerns about your cleanup.
Pictures
Upload documents, photos, or video files related to your cleanup. You may share up to 5 files.
Drop files here or

Accepted file types: pdf, doc, docx, txt, rtf, jpg, jpeg, gif, mp3, mp4, m4a, zip, tif, tiff, png, wpf, odt, wav, mov, xls, wpd, ppt, pptx, avi, mpg, xlsx, sib, mus, 3gp, flv, webm, psd, ai, mobi, epub, wmv, eps, key, ogg, aac, flac, aiff, wma, mkv, musx, ibooks, iba, tex, bbl, ltx, m4v, svg, fdx, dwg, vsd, vss, vst, vdx, vsx, vtx, mpp, mpx, Max. file size: 5 MB, Max. files: 5.