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2. Please complete the online form below to submit your clean up report. 

4. First Name*
5. Last Name*
7. Phone Number*
8. Email Address*
10. Are you:*
    -- Select One --IndividualGroupAdopt-a-Spot Group
12. You group name:*
14. How many adult volunteers participated? *
16. How many youth volunteers participated?
20. Cleanup Location (Road or Park Name)
22. Date of Cleanup
    Date of Cleanup
23. Hours Completed
24. How many bags of trash were collected?
26. How many miles were cleaned?
28. Upload photos of your cleanup here!
30. Please leave your comments or questions below.
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field