Adopt-A-Road Collection Report

Submit after every cleanup

The City of Knoxville, Knox County Solid Waste, and Keep Knoxville Beautiful Adopt-A-Road program requires regular reporting from Adopt-A-Road groups for each clean-up a group performs. Collection reports are used to judge which groups are active, but more importantly, to report the information for the grant that funds the program. Therefore, it is imperative that the collection report is turned in by groups in a timely manner after every cleanup. Failure to return updated copies of this report after cleanups may result in termination of the group’s Adopt-A-Road status. Please complete the form below or print off this form to be emailed or mailed to Keep Knoxville Beautiful.

For questions filling out this form please contact adoptaroad@keepknoxvillebeautiful.org or call 865-521-6957.

Group Name

Spokesperson Name

First Name

Last Name

Spokesperson Email Address

Spokesperson Phone Number

(###)

###

####

Road Name

Date of litter pickup

YYYY

Number of volunteer

Number of hours

Miles or road (est.)

Number of bags

Bag Disposal Method

Knox County Litter Crew Pick-Up or City of Knoxville Public Service (please state exactly where bags are located in the comment box below)

Our volunteer group properly disposed of the bags ourselves

Any unusual items, interesting stories, or additional comments about your pick-up event you would like to share?

*Please send any photos to adoptaroad@keepknoxvillebeautiful.org