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Adopt A Spot Cleanup Report Form

2. Keep Norfolk Beautiful Cleanup Report Form

   Remember cleanups are due 4 times a year! At least once every 3 months. Thank you for keeping Norfolk beautiful!
4. Group Name*
6. Group Leader*
7. E-mail*
8. Phone*
10. Cleanup Location*
11. Date of Cleanup*
13. Number of full WHITE bags collected?*
14. Number of full BLACK bags collected?
16. Number of ADULT volunteers*
17. Number of CHILDREN volunteers*
19. Estimated weight of bulky items
20. How long did the cleanup last?*
    Round off to the nearest 1/2 hour
22. Number of trees planted
23. Number of plants planted
    shrubs, flowers, bulbs, etc.
24. Number of bags for recycling
    must be taken home or to one of our drop off recycling centers
26. Location for trash pickup*
28. I reviewed the safety guidelines with ALL volunteers*

    1. Yes
29. Upload Sign In Sheet Here*
Leave This Blank:


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

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field