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 or call 865-521-6957.

Spokesperson Name *
Spokesperson Name
Spokesperson Phone Number
Spokesperson Phone Number
Date of litter pickup *
Date of litter pickup
Bag Disposal Method *

*Please send any photos to