Adopt-A-Path Log Activity

2. Record pathway pick-up activity. If you have not already adopted a path, please use the Adopt-A-Path Application form.

4. First name:*

5. Last name:*

7. Email:

8. Telephone:*

10. Address:*

12. City:*

13. State:*

14. ZIP:*

16. Preferred method of response:*
    -- Select One --EmailTelephoneMail

18. Please describe the pathway location by referencing the intersection of the closest street or streets.

20. Please enter the group responsible for pathway pick-up, as noted on your adopt-a-path application.

22. Date of pickup (mm/dd/yyyy):

23. Time spent in activity (in minutes):

25. Number of participants:

26. Size of bags used:
    -- Select One --3- to 5-gallon (plastic grocery bag)8-gallon13-gallon22-gallon30-gallon33-gallon

27. Total number of bags filled:

29. TRASH - number of bags half-filled or more:

30. RECYCLABLES - number of bags half-filled or more:

32. Comments about your pathway clean-up:

Leave This Blank:


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

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field