Adopt-a-Spot Clean-up Report Form

Reports should be submitted by the last day of September, October, November, January, February, March, and April. Reports should be submitted by the last day of exams in December and May.

Organization/Group Name:*

Spot Location:*

Name of Person Completing this Report:*

E-mail:*

Date of Clean-up:*

Length of Time Spent Cleaning (round to nearest half hour):*

Number of Group Members Participating:*

Total Number of Bags Collected:*

Any other bulky debris collected? (e.g. tires, wood, items too big to be bagged)*

If yes, please explain (e.g. type, size, location, etc.):

Any other problems, questions, or concerns?