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2. Clean City Project Supplies Request Form
   Adopt-A-Spot Program volunteers help keep our city clean and beautiful. Volunteers clean an adopted spot five times a year for two years, and in return, receive city-wide recognition for their efforts. In addition, volunteers have access to cleanup equipment and supplies - you can order supplies on-line below!
   
   *All fields are required.
4. First & Last Name*
6. Email*
7. Phone Number*
9. Organization Name*
   Enter NA if not part of a group.
11. Project Site*
13. Number of People*
14. Planned Project Date*
15. Date to Pick Up Supplies*
17. Number of Litter Sticks
    Bags, safety vests, and gloves will be based on the number of litter sticks requested unless they are entered separately.
18. Please select type of bag (small), (medium), (large), (extra large)
    -- Select One --SmallMediumLargeExtra large
19. Number of Bags
20. Number of Safety Vests
22. Number of Gloves
    Indicate glove sizes if specific sizes needed - small, medium, large, or extra large.
23. Number of Buckets
    Limited number available
24. Number of Clicker Counters
    Limited number available
26. Number of Shovels
    Limited number available
27. Number of Rakes
    Limited number available
29. Additional Comments
    Additional information about how we can support you
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

* indicates a required field