Adopt-A-Road Post Cleanup @ @ Gwinnett Clean & BeautifulGwinnett Clean & Beautiful

Adopt-A-Road Post Cleanup

Please complete this form as soon as your Adopt-A-Road group finishes a cleanup.

Adopt-A-Road Contact Information
Group Name
Contact Name
FirstLast
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Daytime Phone
Evening Phone
Email
Cleanup Details
Date of Cleanup
Location of Cleanup
# of Bags of Garbage Collected
# of Illegal Signs Collected
Approximate Weight of Garbage (20lbs/bag)
# of Volunteers
# of Hours Worked
Do you need a DOT pickup?
If you need a DOT pickup, please provide details on the location where the bags/signs were left.
How would you improve the Adopt-A-Road program?
Any other comments/suggestions?
Photo Upload

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